Objective To evaluate the clinical effect of clopidogrel combined with low molecular weight heparin (LMWH) on chronic pulmonary heart disease in patients with acute exacerbation.Methods Eighty cases of patients with chronic pulmonary heart disease with exacerbation were randomly divided into treatment group (40 cases) and control group (40 cases).Patients in control group were administrated with conventional treatment including infection control,cough,phlegm,relieving spasm and asthma,persistent low flow oxygen,maintain airway patency,strong heart,diuresis,anti arrhythmia.Patients in treatment group were treated with subcutaneous injection of low molecular weight heparin and oral clopidogrel therapy beside routine treatment.Plasma prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time (TT),fibrinogen(Fb) and pulmonary function(FEVI) were measured.Results (1) After treatment,Fb in treatment group and control group were (3.92 ± 1.11) g/L,(4.54 ± 1.41) g/L respectively.While PT,APTT,TT and FEVI in treatment group were (13.02 ± 1.52) s,(33.21 ± 4.03) s,(14.03 ± 2.52) s,(45.73 ± 7.38) ％ respectively,significantly higher than the control group ((11.31 ± 2.01) s,(30.13 ± 3.59) s,(12.88 ± 2.11) s and (40.12 ± 6.99) ％,P ＜0.05).(2) In control group,FEVI after treatment significantly improved than that of before treatment (t =4.821 ; P ＜ 0.05),while PT,APTT,TT were no significant changes (P ＞ 0.05).PT,APTT,TT,FEVI in treatment group were significantly improved after treatment than that of before treatment(P ＜ 0.05).(3) The clinical effective rate in treatment group was 80.0％ (32/40),higher than that in control group (65.0％(26/40) x2 =4.815; P ＜0.05).Conclusion The therapy scheme of clopidogrel combined with low molecular heparin calcium is proved to be an efficacy method for reducing sputum viscosity,antiinflammatory,anti allergic effect,platelet aggregation,increasing pulmonary blood flow,improving the condition of patients with pulmonary heart diseasethe.And its clinical effect is significant,worthy to promote and apply.

Colorectal cancer is a malignancy with poor prognosis and high mortality and is caused by multiple factors. Colonoscopy,flexible sigmoidoscopy,guaiac-based fecal occult blood test,immunochemical fecal occult blood test,fecal DNA test,CT colonoscopy and serum carcinoembryonic antigen test are the methods frequently used for screening of colorectal cancer,but they all have certain limitations. Elevation of methylation of SEPT9 is associated with the pathogenesis of colorectal cancer,and detection of the level of methylation of SEPT9 in peripheral blood can be used for screening of colorectal cancer in susceptible population. This article reviewed the application of peripheral blood SEPT9 DNA methylation assay for screening of colorectal cancer.

Control of hypertension is essential for stroke prevention. For most patients, the monotherapy often fails to lower blood pressure to normal levels, while the combination therapy can increase the effect of lowering blood pressure, however, not all the antihypertensive drugs have good efficacy. The early data analysis of the Chinese Hypertension Intervention Efficacy Study and the subgroup analysis of the KYOTO HEART study have showed that dihydropyridine calcium channel blocker amlodipine and angiotensin receptor blocker valsartan are both the most effective antihypertensive drugs in the prevention of stroke.

Objective To evaluate the effect of an equivalent uiform dose optimization (EUD) based optimization algorithm in sparing the organ at risk (OAR) of tumor treated with intensity-modulated radiation therapy (IMRT).Methods 10 patients of nasopharyngeal carcinoma (NPC),10 patients of esophagus cancer,6 patients of rectum cancer were randomly selected from all patients received IMRT treatment.Then physical optimization constraints (dose/dose-volume constraints) were designed as EUD optimization,while the physical objectives for targets and other OAR were unchanged.Results There was statistically significant difference in protecting OAR in 8 NPC patients of PLANED group compared with those of PLANNO_EuD group (t values were 2.590,2.352,3.656,2.148,2.283,3.683,2.192,2.353,2.146,2.276,2.126,P ＜ 0.05).There was no statistically significant difference in protecting OAR in 10 cases of esophageal cancer between PLANEUD group and PLANNO_EUD group (t value were 0.408,0.427,0.920,P ＞ 0.05).There was statistically significant difference in protecting OAR in 6 cases of rectum cancer of PLANED group compared with those of PLANNO_EUD group (t values were 2.332,2.693,2.279,2.244,P ＜ 0.05).Conclusion EUD optimization can reduce the doses to OAR which may be quite helpful to reduce the occurrence rate of OAR complications.

Objective To investigate the myocardial protection effect of dexmedetomidine hydrochloride during off-pump coronary artery bypass graft surgery. Methods Forty patients undergoing off-pump coronary artery bypass grafting were randomly divided into two groups:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine hydrochlo-ride was given at a loading dose of 0. 5 μg?kg-1 to patients in group D, and then infused continuously at a rate of 0.5 μg?kg-1?h-1.The same amount of saline was given to patients in group C. After loading dosing,general anesthesia was per-formed with TCI technique.Trans-esophagus Doppler monitoring was conducted to monitor the blood volume and heart function, and close monitoring of fluid infusion to maintain stable circulation.Invasive blood pressure and heart rate were recorded every 5 min. Blood samples were taken for detection of cTnI,CK-MB,TNF-αand IL-6 contents at the following time points:after induction ( t0 ) ,before operation ( t1 ) ,after operation ( t2 ) ,12 h postoperation ( t3 ) and 24 h postoperation ( t4 ) . Results The blood pressure and heart rate decreased significantly at t0 and t1 in group D compared with group C,and there were no significant differ-ences in the two indexes at other time points between the two groups.Blood CK-MB,cTnI and inflammation factors TNF-α,IL-6 were much higher at t2,t3,t4 than at t0 and t1 in both groups(P<0.05).They were significantly decreased at t2,t3,t4 in group D relative to group C (P<0.05).Vessel active medicines were less given after the operation in group D (P<0.05). Conclusion Dexmedetomidine hydrochloride can mitigate the inflammation responses caused by off-pump coronary artery bypass grafting,re-duce the myocardial injury and improve the cardiac function of the patients.

Objective To investigate the expression of β-arrestin2 and microtubule-associated pro-tein light chain(LC)3 in renal of rat with acute renal ischemia reperfusion injury,and to analyze the relation-ship between them and renal injury. Methods Fifty-four male SD rat(3-4 weeks old) were randomly divid-ed into three groups:control group,sham group,acute ischemic reperfusion injury group. We established the acute renal ischemia reperfusion injury model through removing the right kidney and clamping the left renal for 45 minutes with noninvasive arterial clip. We obtained the kidney and blood samples respectively at 12 h, 24 h,36 h,48 h,72 h,96 h after the surgery. Expressions ofβ-arrestin2 and LC3 protein were detected by the immunohistochemistry method and Western blot method. The renal function and morphological changes were assessed. Results Compared with control group and sham group,the serum creatinine and kidney pathologi-cal grading of acute ischemia reperfusion injury group obviously rised. The kidney injury was the most serious at the 24 h after acute ischemic reperfusion injury. The expressions of β-arrestin2 and LC3 were little in the control group and sham group. However,the expressions of these two indicators were obviously higher and reached the peak at the 12 h after acute ischemia reperfusion injury. All these results suggested that the chan-ges of these two indicators were anterior to the histopathological changes. The expressions ofβ-arrestin 2 and LC3 protein were in positive correlation with the kidney injury(r=0. 821,P<0. 05;r=0. 913,P<0. 05). Conclusion In the acute renal ischemia-reperfusion injury,β-arrestin2 may be as a kind of upstream regula-tory protein involving in the kidney pathological process through the regulation of the autophagy.

Objective　To evaluate the results and feasibility of US-guided radio-frequency(RF) ablation for the treatment of primary or secondary liver tumors.Method　180 patients with liver tumor were treated with percutaneous ultrasound-guided RF ablation.RF was applied by a frequency at 10W with an increase of 10W every other minute until 90W for a total of 15 minutes,using single or multi puncture method.After RF treatment,the α-fetoprotein(AFP) level was examined,the ultrasonograph,computered tomography(CT),biopsy were performed.Results　In those with abnormal pretreatment AFP level,1 week after RF treatment AFP returned to normal in 119/153(77.8%)patients;2-4 weeks later or after the second treatment AFP drops to normal in 144/153(94.1%) patients.Tumors failed to grow or shrank in size,some underwent liquefaction on CT and ultrasound follow-up.The biopsy results of the treated lessions showed necrosis accompanied with microvessel thrombosis.Abdominal pain disappeared or relieved in 121/142(85.2%) patients.Ascites and temporary jaundice occured in 26/180(14.4%),and 16/180(8.9%) patients,respectively.Conclusion　RF ablation is a mini-invasive,safe,effective treatment for primary and secondary liver tumor.

Objective To investigate the expression of IGF-1 in cerebral tisse,and its correlation with Glutamate expression and neuronal apoptosis,and to study the role of IGF-1 in the pathophysiologie process of ICH.Methods ICH model was induced in rats by infusing 50?l autologous blood into the eaudate nucleus with stereotaetie device.The animals were randomly divided into sham-operation group,ICH group and exogenous IGF-1 intervention group.Every rat was killed and brain tissue was collected.Immunohistoehemitry assay was used to detect the expression of IGF-1 and Glutamate,and TUNEL method used to detect apoptosis in cerebral tissues.Result At 2 hours after ICH,IGF-1 positive cells appeared around the hematoma in the brain,peaked after 24 hours,and returned to normal level on the 7th day. Glutamate positive cells appeared around the hematoma at 2 hours,peaked on the 3rd day,and its high level expression lasted to the 7th day.TUNEL- positive cells appeared at 8 hours,peaked on the 3rd day,and few apoptotic ceils could be found on the 7th day.The expression of IGF-1 was positively correlated with apoptotie cells and the expression of Glutamate.The amounts of Glutamate positive cells and TUNEL positive cells were significantly reduced after intervention with exogenous IGF-1.Conclusion IGF-1 participated in the pathophysiologic course of ICH.IGF-1 repaired and protected the brain tissue from damage after ICH.

A total of twenty eight HSV isolates from the patients were typed by using HSV typespecific monoclonal antibodies (McAb). Comparison of typing results with McAb in three Sero-lminunological methods with molecular hybridization indicated 100% concordance in the results. But the typing rates were quite different among the various methods (ELISA 64%, IFA and EIA 82%, Hybridization 100%). The results demonstrate that the molecular hybrydization with HSV type-specific probes was highly sensitive and specific, and the method of EIA with HSV type-specific McAb was accurate, cheap, rapid and practical.