OBJECTIVE:To explore the difference of genotypes in patients with coronary artery disease(CAD)and different responses to clopidogrel. METHODS:Totally 159 CAD patients were selected from cardiology department of our hospital during Mar. 2013-Nov. 2015. They were given clopidogrel+aspirin for dual antiplatelet therapy for at least 1 year. Turbidimetry method was used to detect the percentage of platelet aggregation induced by adenosine diphosphate (ADP) and arachidonic acid (AA) before and after treatment. The polymorphism of cytochrome P450(CYP)2C19,CYP3A5,wild type leucine 33 allele(PLA1)/proline 33 al-lele(PLA2)were detected by PCR-RFLP. RESULTS:There were 3 kinds of CYP2C19 genotypes(2/2,2/1,1/1),3 kinds of CYP3A5 genotypes (3/3,3/1,1/1) and 3 kinds of PLA1/PLA2 genotypes (A1/A2,A2/A2,A1/A1);the frequency of each genotype was in line with Hardy-Weinberg balance(P>0.05). Among 159 cases,there were 81 cases of clopidogrelsemi-re-sponse,accounting for 50.9%;78 cases of clopidogrelresponse,accounting for 49.1%. The frequencies of CYP2C19 gene dele-tion(2/2 or 2/1 genotype)and 2 allele in clopidogrelsemi-responsepatients were significantly higher than clopidogrelre-sponsepatients,with statistical significance(P<0.05). The frequencies of PLA1/PLA2 gene deletion(A2/A2 or A1/A2 genotype) and A2 allele in clopidogrelsemi-responsepatients were significantly higher than clopidogrelresponsepatients,with statistical significance(P<0.05). The frequencies of CYP3A5 gene deletion(3/3 or 3/1 genotype)and 3 allele in clopidogrelsemi-re-sponsepatients were slightly higher than clopidogrelresponsepatients,without statistical significance (P>0.05). After treat-ment,the percentage of ADP or AA-induced platelet aggregation in different genotypes patients were significantly lowered,com-pared to before treatment;but the percentage of platelet aggregation in CYP2C19 gene deletion and CYP3A5 gene deletion patients were significantly higher than gene expression patients(1/1 genotype),with statistical significance(P<0.05). There was no sta-tistical significance in the percentage of platelet aggregation between PLA1/PLA2 gene deletion patients and gene expression patients (P>0.05). CONCLUSIONS:The incidence of clopidogrelsemi-responsein CAD patients is high. CYP2C19 and PLA1/PLA2 gene polymorphism may be related to clopidogrelsemi-re-sponse,while CYP3A5 gene polymorphism has no relation-ship with it. CYP2C19 and CYP3A5 gene deletion may weaken inhibitory effects of clopidogrel on platelet aggregation of CAD patients.

OBJECTIVE:To observe the effect of rosuvastatin on prognostic of patients with paroxysmal atrial fibrillation (AF) after circumferential pulmonary vein ablation. METHODS:75 patients with paroxysmal AF were divided into observa-tion group(n=39)and control group(n=36)according to the admission single. All patients underwent circumferential pulmo-nary vein ablation antiarrhythmic treatment. Control group orally received warfarin sodium,amiodarone,metoprolol,and sub-cutaneous injected low molecular weight heparin. Observation group additionally received 10 mg Rosuvastatin tablet,qd on the basic of contol group. Changes of cardiac function,inflammatory factors,lipid levels in 2 groups before and after treat-ment were observed,and follow-up results were compared. RESULTS:There was no significant difference in left atrial diame-ter and left ventricular ejection fraction in 2 groups before and after treatment (P>0.05);atrial effective refractory periods (AERP)in 2 groups significantly prolorged,and observation group prolorged more significantly than control group,the differ-ence was statistically significant(P<0.05). Serum high sensitivity C-reactive protein,interleukin-6 48 h and 1 month after op-eration in 2 groups significantly increased,and control group was significantly higher than observation group,the difference was statistically significant (P<0.05);before operation and after 3 months of operation,there was no significant difference in inflammatory cytokine levels(P>0.05). Triglyceride and low density lipoprotein cholesterol in observation group 1 month after operation significantly decreased, HDL-C significantly increased, there were significant differences (P<0.05). Fol-low-up time was (23.91 ± 5.28) months,AF recurrence was 7.8%,which was significantly lower than control group (13.9%),the difference was statistically significant (P<0.05);and there were no significant differences in ablation-related atrial tachycardia (ATa) and the incidence of adverse reactions between 2 groups (P>0.05). CONCLUSIONS:Rosuvastatin can effectively inhibit the inflammatory reaction and prolong the AERP,thereby reducing the recurrence rate of AF,with good efficacy and safety.

Objective To analyze the effect of different concentrations of tacrolimus on nephrotic syndrome.Methods A total of 90 kidney disease cases in our hospital from May 2012 to May 2016 were as research objects,the tacrolimus blood concentration was determined by ELISA method when blood concentration reached steady state after taking tacrolimus.All patients were followed up for 3 months to observe the efficacy,dosage and concentration of the drugs,and the incidence of adverse reactions was analyzed.Results After treatment,there were 76 cases with complete remission (84.4%),9 cases (10%) with partial remission,5 cases (5.6%) in invalid.The complete remission group,partial remission group and ineffective group dosage were (0.05±0.01) mg/(kg·d),(0.06±0.01) mg/(kg·d),and (0.07±0.02) mg/(kg·d),respectively.The concentration of drug in blood were (8.44±3.25) ng/mL,(5.92±1.53) ng/mL,and (3.34±0.86) ng/mL.Adverse reaction rates were 45.6% and 44.4% in complete remission group and partial remission group,which were significantly higher than 20.0% in the invalid group,the differences were statistically significant (P<0.05).Conclusion Different concentrations of tacrolimus have an effect on the treatment of nephrotic syndrome,the whole blood concentration of tacrolimus controlled in 5.19~11.69 ng/mL can reach satisfactory effect.

Objective To analyze the effect of different concentrations of tacrolimus on nephrotic syndrome.Methods A total of 90 kidney disease cases in our hospital from May 2012 to May 2016 were as research objects,the tacrolimus blood concentration was determined by ELISA method when blood concentration reached steady state after taking tacrolimus.All patients were followed up for 3 months to observe the efficacy,dosage and concentration of the drugs,and the incidence of adverse reactions was analyzed.Results After treatment,there were 76 cases with complete remission (84.4%),9 cases (10%) with partial remission,5 cases (5.6%) in invalid.The complete remission group,partial remission group and ineffective group dosage were (0.05±0.01) mg/(kg·d),(0.06±0.01) mg/(kg·d),and (0.07±0.02) mg/(kg·d),respectively.The concentration of drug in blood were (8.44±3.25) ng/mL,(5.92±1.53) ng/mL,and (3.34±0.86) ng/mL.Adverse reaction rates were 45.6% and 44.4% in complete remission group and partial remission group,which were significantly higher than 20.0% in the invalid group,the differences were statistically significant (P<0.05).Conclusion Different concentrations of tacrolimus have an effect on the treatment of nephrotic syndrome,the whole blood concentration of tacrolimus controlled in 5.19~11.69 ng/mL can reach satisfactory effect.

Objective: To evaluate the effects of parallel versus perpendicular double plating for distal humerus fracture of type C. Methods: A standardized comprehensive literature search was performed by PubMed, Embase, Cochrane library, CMB, CNKI and Medline datebase.Randomized controlled studies on comparison between parallel versus perpendicular double plating for distal humerus fracture of type C before December 2015 were enrolled in the study.All date were analyzed by the RevMan 5.2 software. Results: Six studies, including 284 patients, met the inclusion criteria.There were 155 patients in perpendicular double plating group, 129 patients in parallel double plating group.The results of Meta-analysis indicated that there were statistically significant difference between the two groups in complications (OR=2.59, 95%CI: 1.03 to 6.53, P=0.04). There was no significant difference between the two groups in surgical duration (MD=-1.84, 95% CI: -9.06 to 5.39, P=0.62), bone union time (MD=0.09, 95%CI: -0.06 to 0.24, P=0.22), Mayo Elbow Performance Score (MD=0.09, 95%CI: -0.06 to 0.24, P=0.22), Range of Motions (MD=-0.92, 95%CI: -4.65 to 2.81, P=0.63) and the rate of excellent and good results (OR=0.64, 95%CI: 0.27 to 1.52, P=0.31). Conclusion Both perpendicular and parallel double plating are effective in distal humerus fracture of type C, parallel double plating has less complications.

We have developed a rapid and high throughput lipase-ANS (8-Anilino-l-naphthalenesulfonic acid) assay to evaluate the thermo-stability of lipases based on the ANS fluorescence signal's increasing and shifting when this small fluorescence probes binds to lipase. The testing lipase samples were incubated at a temperature range of 25 degrees C to 65 degrees C for 30 min before mixed with ANS solution (0.20 mg/mL lipase and 0.05 mmol/L ANS in the buffer of 20 mmol/L Tris-HCl, 100 mmol/L NaCl, pH 7.2) in a cuvette or microplate. Fluorescence signals of the samples were measured at EX 378 nm, EM 465 nm with a fluorescence photometer or a plate reader, and Tm was calculated with the software of GraphPad Prism5.0. The Tm values of several mutants of Penicillium expansum lipase (PEL) were measured with this ANS assay and conventional method simultaneously and the results show that Tm values are comparative and consistent between these methods, suggesting that the lipase-ANS assay is a reliable, rapid and high throughput method for lipase thermo-stability measurement.
Anilino Naphthalenesulfonates ; chemistry ; Enzyme Stability ; High-Throughput Screening Assays ; methods ; Hot Temperature ; Lipase ; metabolism ; Spectrometry, Fluorescence

Objective To analyze the prognostic value of vascular endothelial growth factor in acute leukemia .Methods 73 pa-tients with acute leukemia as the leukemia group and 80 patients as the control group were selected .The serum and bone marrow tissue taken by puncture biopsy of posterior superior iliac spine of the leukemia group were collected The serum of the control group was collected and compared .The expression of vascular endothelial growth factor was detected by immunohistochemistry .Results The acute leukemia patients with positive and negative serum VEGF or with positive and negative bone marrow VEGF were fol-lowed .The positive expression of serum VEGF was found in 19 recurrent cases of acute myeloid leukemia (57 .58% ) and the nega-tive expression of serum VEGF was found in 1 recurrent cases (20 .00% ) .The recurrence rate in patients with positive serum VEGF was higher than that in patients with negative serum VEGF ,and the difference was statistically significant (P<0 .05);the positive expression of serum VEGF was found in 16 recurrent cases of acute lymphoblastic leukemia (51 .62% );the positive expres-sion of bone marrow VEGF was found in 17 recurrent cases of acute myeloid leukemia and 17 recurrent cases of acute lymphoblastic leukemia respectively (48 .57% ) .The serum VEGF level and the bone marrow VEGF were measured on follow-up one year after treatment ,which showed the levels of recurrent cases of acute myeloid leukemia and acute lymphoblastic leukemia were all higher than those of Remission patients ,and the difference was statistically significant (P< 0 .01) .Conclusion The levels of VEGF in blood and bone marrow cells can be highly expressed in the initial treatment and recurrence of acute leukemia ,especially in the re-lapsed condition ,the expression level is higher ,but the expression level is significantly decreased in the remission state .Increased expression of VEGF in blood and bone marrow cells may help to predict an increased risk of recurrence .

Objective:To explore the early outcomes surgical treatment with growing rod for idiopathic early-onset scoliosis (IEOS).Methods:Data of 11 patients with IEOS who had surgical treatment from February 2017 to December 2018 were retrospectively analyzed. There were 4 males and 7 females aged 6.45±1.63 at the time of the first operation, with preoperative Cobb angle of 74.74°±6.48° (range, 66.12°-87.85°). The imaging data and clinical data before operation, after operation instantly, 1 month after operation, 1 year after operation and 2 years after operation, and surgical-related complications were analyzed and recorded.Results:All the 11 patients were followed up for 28.82±4.77 months. The Cobb angle was 74.74°±6.48° before the initial implantation of internal fixation, and decreased to 30.30°±4.04° immediately after the operation, 30.39°±4.49° 1 month after the operation, 26.93°±3.09° 1 year after the operation, and 28.36°±2.98° 2 years after the operation. The correction rate was 61.82%±4.85% 2 years after operation. The height of T 1-T 12 thoracic vertebra was 13.69±2.05 cm before surgery, and increased to 20.74±3.10 cm immediately after surgery, and was 20.85±3.62 cm 1 month after surgery, 21.49±3.56 cm 1 year after surgery, and 22.54±3.63 cm 2 years after surgery. The height of T 1-S 1 vertebral body was 24.21±3.20 cm before surgery, and increased to 31.04±3.79 cm immediately after surgery, and was 30.85±3.64 cm 1 month after surgery, 32.91±3.24 cm 1 year after surgery, and 34.46±3.28 cm 2 years after surgery. Preoperative apical vertebral translation (AVT) was 7.45±2.00 cm before the initial operation, and shortened to 2.04±0.67 cm immediately after the operation, 2.07±0.70 cm 1 month after the operation, 2.24±0.57 cm 1 year after the operation, and 2.11±0.82 cm 2 years after the operation. There were statistically significant differences in the above indexes before surgery, 1 month after surgery, 1 year after surgery and 2 years after surgery. Compared with preoperation, pulmonary function FEV1 and FVC increased to 1.28±0.13 L and 1.49±0.10 L, respectively, 1 year after surgery, and 1.34±0.13 L and 1.54±0.12 L, respectively, 2 years after surgery. Pulmonary function was significantly improved 1 year after surgery, and pulmonary FVC was positively correlated with T 1-T 12 thoracic vertebral height ( r=0.838, P< 0.001). 13 complications were found in the 11 patients, including 2 cases of proximal screws loosening, 1 case of proximal junction kyphosis, 1 case of titanium rod fracture, 3 cases of skin swelling cause by internal fixation, and 6 cases of subcutaneous effusion, with good results after timely treatment. Conclusion:The traditional growing rod can effectively control the progression of deformity in patients with IEOS, maintain the growth and development of trunk, and promote the development and maturation of lung function.

Objective:Gastric adenocarcinoma of the fundic gland type (GA-FG) is rare and often occurs in patients who are not infected with Helicobacter pylori. The current study analyzed and summarized the clinical, endoscopic, and pathological features of GA-FG, in an effort to improve its diagnosis. Methods:Patients who were diagnosed with GA-FG and treated with endoscopic submucosal dissection (ESD) resection at the Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University from January 1st 2020 to October 1st 2022 were included in the study. Their clinical manifestations, endoscopic features, pathological immunohistochemistry, and other characteristics were analyzed.Results:A total of 14 patients with GA-FG were included in the study, 5 males and 9 females, with a mean age of 59 years. Most had no substantial clinical manifestations. Twelve patients were H. pylori-negative, all patients underwent ESD resection, and all patients survived during the follow-up period of 13±9 months. Eleven patients had postoperative endoscopic follow-up records, and no recurrence was detected. Fifteen lesions were detected (2 were present in 1 patient). Twelve were located in the upper 1/3 of the stomach, 10 were ≤ 1 cm in diameter, 12 had a morphology of type 0-Ⅱa, 8 had visible discoloration changes, and 12 had visible vasodilation on the surface. Magnified endoscopy and narrow-band imaging indicated that 12 of the lesions had enlarged marginal crypt epithelium, without any obvious microvascular pattern abnormalities and no obvious borderline. After resection the pathological specimens were all without vascular infiltration, and there was no atrophy of the mucosa at the edge of the lesion. In immunohistochemistry analyses MUC-2 was negative in all cases. MUC5AC was negative in 11 cases, MUC-6 was positive in all cases, and Ki-67 was ≤ 5% in 12 cases. Conclusions:GA-FG is a newly identified type of gastric cancer with low malignancy and a good prognosis. Characteristic discoloration and surface dilated vessels are often evident endoscopically. Enlarged marginal crypt epithelium and no visible boundary lines are often apparent in magnification endoscopy and narrow band imaging.

Oral and maxillofacial malignant tumors threaten the life and health of patients, and seriously affect their swallowing, language function and face. 125I seeds brachytherapy for oral and maxillofacial malignant tumors has been widely concerned and studied because of its advantages such as less surgical trauma, large and uniform dose distribution in the target tissue, little damage to the surrounding normal tissue, and reducing radiation exposure of medical staff. Low-dose brachytherapy with 125I seeds can effectively reduce the tumor volume and prolong the survival time of patients. This article reviews the clinical application of 125I seeds brachytherapy in oral and maxillofacial malignant tumors.