Objective To compare the risk effects of different antiplatelet therapies on gastrointestinal injury and summarize the endoscopic characteristics of gastrointestinal mucosal injury in the elderly. Methods The dyspepsia symptoms, gastrointestinal bleeding and endoscopic findings were retrospectively evaluated among 577 patients who received the antiplatelet therapy with aspirin and/or clopidogrel. Results The risk of dyspepsia symptoms and gastrointestinal bleeding was slightly higher in clopidogrel group than in aspirin group (both P＞0.05, x2=0.48, 0.72), and OR (95% CI): 1.10 (0.59-2.07) and 1.74 (0.48-6.33), for the risk of dyspepsia symptoms and gastrointestinal bleeding, respectively. In aspirin plus clopidogrel group, the risk of dyspepsia symptoms had no significant increase as compared with aspirin or clopidogrel group (x2=0.37, 0.03, for aspirin or clopidogrel group, respectively, both P＞0.05), but the risk of gastrointestinal bleeding was significantly higher than in aspirin group (x2=5.43, P＜0.05), OR (95% CI): 4.77 (1.15-19.79) and slightly higher than in clopidogrel group (P＞0.05). In this study, 57 patients received endoscopy and the detection rate of erosion or ulcer was 78.9%. Erosion (61.4%) was most in the gastric antrum; gastric ulcer (10.6%) located in gastric antrum and angle; duodenal ulcer (18.0%) located in bulb. In patients with dyspepsia symptoms erosion (70.5%), were most likely found but patients with gastrointestinal bleeding showed mainly ulcer (69.2%). Conclusions In the elderly the use of clopidogrel alone is not safer than low-dose aspirin and the combination would increase the risk of gastrointestinal bleeding. The detection rate of erosion or ulcer is high in patients with symptoms. Patients with dyspepsia symptoms most likely show erosion, but patients with gastrointestinal bleeding have mainly ulcer and complex ulcers more common.

OBJECTIVE:To establish a method for determining the contents of chlorogenic acid and luteoloside in Lonicerae ja-ponicae,and to explore the shelf life of L. japonicae under ordinary temperature and sealed environment. METHODS:HPLC meth-od was adopted. The determination was performed on Agilent Zorbax SB-C18(chlorogenic acid)column and Agilent Zorbax SB-Phe-nyl(galuteolin)with mobile phase consisted of acetonitrile-0.4% phosphoric acid(13:87,V/V),acetonitrile-0.5% glacial acetic ac-id (gradient elution,galuteolin) at the flow rate of 1.0 mL/min. The detection wavelength was set at 327 nm (chlorogenic acid) and 350 nm(galuteolin). The column temperature was 30 ℃,and sample size was 10 μL. RESULTS:The linear range of chloro-genic acid and galuteolin were 10-100 μg/mL(r=0.9986),5-50 μg/mL(r=0.9993),respectively. RSDs of precision,stability and reproducibility tests were all lower than 4.0%. Recoveries were 95.78%-99.70%(RSD=1.46%,n=6)、96.30%-104.31%(RSD=2.93%,n=6). The contents of chlorogenic acid and galuteolin in roller method,baking method and natural drying method of processed L. japonicae were all decreased by 30%-40% after stored for 12 months. CONCLUSIONS:The method is simple, precise,stable and repeatable,and can be used for simultanoue determination of chlorogenic acid and luteoloside in L. japonicae. The contents of active components in L. japonicae decrease significantly after stored for 12 months. It is necessary to establish shelf life standard of L. japonicae,so as to guarantee the effectiveness of drug use in the clinic.

AIM: To study the HPLC fingerprints and establish a sensitive and specific method for the quality control of Andrographis paniculata(Burm.f.) Nees. METHODS: All 23 samples of Andrographis paniculata(Burm.f.) Nees collected from 10 different places were determined by RP-HPLC.Shimadzu-ODS column was used with maxtures of 0.1% formic acid-acetonitrile and 0.2% formic acid-water as mobile phase in gradient mode.The flow rate was set at 1.0 mL/min.The column temperature was set at 25℃ and detecting wavelength at 254 nm.Hierarchical clustering,nonlinear mapping and similarity criteria were applied to evaluate the fingerprints. RESULTS: The simple and specific method with good repeatability was established.There were different contents of each component contained in habitat samples produced in individual area. CONCLUSION: The proceeding is suitable to differentiate Andrographis paniculata(Burm.f.) Nees from different places conveniently and can be used for the quality control of this herb.

Objective To evaluate the recent impact and long-term effects of recombinant human acidic fibroblast growth factor (rh-aFGF) of cesarean section on women's abdominal incision healing.Methods In 516 cases of cesarean section in women,randomly divided into placebo group (172 cases),spray group (172 cases) and flush group (172 cases).The placebo group received 0.9％ sodium chloride washing abdominal incision suture.The spray group incision suture direcdy after the administration of rh-aFGF spray,per square meter of 3-4 sprays,3-5 times/d.The flush group was given before 2 rh-aFGF dissolved in 10-20 ml of 0.9％ sodium chloride directly after washing the incision suture,then given spray treatment.The recent follow-up of 15 d observed maternal abdominal incision healing.Long term follow-up of 3 months to observe the incision scar formation.Results The abdominal incision heating time was (8.6 ±3.5) d,that was obviously shorter than that in spray group (10.4 ±3.7) d and placebo group (12.7 ± 4.9) d (P ＜ 0.05).The delay healing accounted for 4.2％ (7/166) in flush group,significantly lower than that in placebo group (34/168,20.2％) and spray group (16/165,9.7％) (P＜ 0.05).There was no significant difference in the incidence of fat liquefaction,postoperative infection among three groups (P ＞ 0.05).Flush group exudation,abdominal wall adhesions was lower than placebo group and spray group [2.4％(4/166) vs.10.1％(17/168),5.5％(9/165),3.6％(6/166) vs.17.3％(29/168),9.7％(16/165)](P＜0.05).Long term follow-up,flush group scar area than spray group reduced by 13.5％,than placebo group reduced by 27.2％.Conclusions A recent rh-aFGF can reduce the cesarean section abdominal incision healing time and reduce abdominal wall adhesions and exudation;rh-aFGF the best dosage is intraoperative irrigation treatment spray combined with postoperative.

Objective To evaluate the effect of a nurse-lead rehabilitation training on quality of life and psychotic symptoms of schizophrenia inpatients. Methods Totally 190 schizophrenia inpatients were divided into the intervention group (96 cases) and the control group (94 cases). In addition to rehabilitation activities which can be chosen freely, the schizophrenia in the intervention group received rehabilitation training including medication training, life skills training, social skill training and physical training, while the schizophrenia in the control group could only chose rehabilitation activities freely. The quality of life and the psychotic symptoms of the schizophrenia while enrolled and discharged were evaluated. Results No significant difference was found in the score of Schizophrenia Quality of Life Scale (SQLS) and Brief Psychiatric Rating Scale (BPRS) between the two groups(P>0.05)while enrolled. The scores of SQLS, psychosocial and motivation/energy in the control group were 30.22 ± 17.21, 30.22 ± 17.21 and 18.28± 9.33, while 21.41±14.63,19.76± 18.85 and 15.95± 8.80 in the intervention group one month after intervention, the difference was significant (t=-2.14,-2.19,-1.99,P<0.05). The scores of BPRS and hostile suspiciousness in the control group were 26.39 ± 6.37 and 4.11 ± 1.87 , while 23.67 ± 6.37 and 3.44± 1.26 in the intervention group one month after intervention, the difference was significant (t=-2.33,-2.54, P<0.05). Conclusions The nurse-lead rehabilitation training can improve the quality of life and psychotic symptoms of schizophrenia inpatients.

Objective To develop the questionnaire of medication adherence in patients with schizophrenia.Methods Delphi method was used in this study.The questionnaire of medication adherence in patients with schizophrenia was developed based on two rounds of consultation among 14 experts.Results The questionnaire of medication adherence in patients with schizophrenia consisted of 3 dimensions,7 items of each dimension.Conclusions The questionnaire can be used as the tool of evaluation of medication adherence in patients with schizophrenia.Further theoretical and empirical study is needed to verify the questionnaire.

Objective To summarize the etiological,clinical and imaging characteristics of cerebral venous sinus thrombosis (CVST) in children so as to provide the basis for early diagnosis and prompt treatment.Methods All the medical records including clinical manifestations,laboratory data,neuroimaging changes,treatment and short-term prognosis were analyzed retrospectively in 12 cases of CVST hospitalized in Children' s Hospital of Fudan University from Aug 2008 to May 2012.Results (1) Regarding the etiology:of the 12 cases,the causes of CVST were infection (2/12),intracranial tumor (1/12),nephrotic syndrome (2/12),cryptogenic disease (7/12).Seven out of all 12 cases without definite cause were presented subacute or chronic headache associated with progressive or acute exacerbation.Seven cases had been misdiagnosed.(2)Diagnosis:All 12 cases were made a definite diagnosis as CVST after neuroimaging examination of brain magnetic resonance imaging combined with magnetic angiography venography.(3) Short-term prognosis:all the patients were treated with anticoagulation,and 11 cases improved.Four of 7 cases with cryptogenic disease had different degrees of visual impairment,and no improvement were found after the treatment; One patient died although accepted digital subtraction angiography and balloon catheter technique.Conclusions Cerebral venous sinus thrombosis has no specific clinical manifestations and a high rate of misdiagnosis.Increased consideration and prompt magnetic angiography venography play a key role in the accurate diagnosis.Anticoagulation is safe and effective.

Objective To evaluate the role of MCP/DAF expression in the spinal cord in the development of neuropathic pain (NP) induced by chronic constrictive injury (CCI) of the sciatic nerve in rats.Methods Twenty-four Sprague-Dawley rats transfected with MCP/DAF,weighing 200-250 g,were randomly divided into 2 groups (n =12 each) using a random number table:sham operation of transfected rat group (Rsham group) and CCI of transfected rat group (RCCI group).Twenty-four healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 2 groups (n =12 each) using a random number table:sham operation of normal rat group (Nsham group) and CCI of normal rat group (NCCI group).The right sciatic nerve was exposed and 4 loose ligatures wen placed on the sciatic nerve at 1 mm intervals with 4-0 catgut in RCCI and NCCI groups.The right sciatic nerve was only exposed in Rsham and Nsham groups.Paw withdrawal threshold to yon Frey filament stimulation (PWT) and paw withdrawal latency to nociceptive thermal stimulation (PWL) were measured at 1 day before operation (baseline) and 1,3 and 7 days after operation.The animals were sacrificed after measurement of pain threshold on 7 days after operation and the L4,5 segment of the spinal cord was removed for determination of the expression of OX-42 (by immuno-histochemistry) and MCP mRNA and DAF mRNA (by RT-PCR).Results Compared with Nsham group,the PWT and PWL were significantly decreased on 1,3 and 7 days after operation,the expression of OX-42 was up-regulated,and the expression of MCP mRNA and DAF mRNA was down-regulated in NCCI group (P ＜ 0.05),and no significant changes were found in the PWT and PWL on 1,3 and 7 days after operation and expression of OX-42(P ＞ 0.05),and the expression of MCP mRNA and DAF mRNA was up-regulated in Rsham and RCCI groups (P ＞ 0.05).Compared with NCCI group,the PWT and PWL were significantly increased on 1,3 and 7 days after operation,the expression of OX-42 was down-regulated,and the expression of MCP mRNA and DAF mRNA was up-regulated in RCCI group (P ＜ 0.05).Conclusion Up-regulation of MCP/ DAF expression in the spinal cord can inhibit the development of NP in rats and regulation of activation of microglias in the spinal cord is involved in the mechanism.

AIM To investigate whether pioglitazone can protect cortical neurons from lipopolysaccharides(LPS)-induced neurotoxicity and the mechanisms responsible for this protective effect. METHODS After 7 d cultures，cultured cortical neurons were incubated with LPS 10 mg·L~(-1) for 4-24 h with or without other drugs. In co-incubation experiments, other drugs were added to the neurons 30 min or 1 h prior to incubation with LPS. The cell viability was assessed by MTT assay. The neuronal apoptosis was quantified by scoring the percentage of cells with apoptotic nuclear morphology after Hoechst 33258 staining. The cultured cells were then fixed on the 7th day and immunocytochemically stained with phosphorylated JNK1 antibody. The protein expressions of active caspase 3 and phosphorylated JNK1 were measured by Western blot. Nitric oxide (NO) generation was measured by Griess method. RESULTS The decrease of cell viability and the increase of apoptotic cells in cultured cortical neurons were observed incubated with LPS for 24 h compared with the normal controls. The cell viability of cortical neurons was decreased from (100.0±10.9)% in the normal control group to (72.3±2.1)% in the LPS-treated group and the apoptotic cell percentages were increased from (11.5±4.2)% in the normal control group to (39.5±8.2)% in the LPS group. LPS induced the increases in phospho-JNK1, active caspase 3 expression, and NO generation. Pioglitazone 0.01, 0.1 and 1 μmol·L~(-1), respectively inhibited LPS-induced decrease in cell viability and increase of apoptotic morphology, active caspase 3 expression in cultured neurons. In LPS+pioglitazone 1 μmol·L~(-1) group, cell viability was （97.8±9.7）%, the apoptotic cells percentage was (20.6±5.0)%, NO generation (6.8±1.3)μmol·L~(-1). Furthermore, pioglitazone also inhibited LPS-induced the increase in JNK1 phosphorylation and NO generation. JNK inhibitor SP600125 5 μmol·L~(-1) significantly inhibited LPS-induced neurotoxicity, cell viability was increased from (72.3±2.1)% to (109.8±11.8)%, the apoptotic cells percentage from (39.5±8.2)% decreased to (19.1±4.8)%, NO generation from （21.1±5.0）μmol·L~(-1) decreased to（4.0±1.3）μmol·L~(-1). The PPARγ antagonist GW9662 10 μmol·L~(-1) did not reverse the effects of pioglitazone. In LPS+pioglitazone 1 μmol·L~(-1)+GW9662 10 μmol·L~(-1) group, cell viability was (90.7±6.9)%, the apoptotic cells percentage was (23.4±4.1)%, and NO concentration was (5.8±0.7)μmol·L~(-1). CONCLUSION Pioglitazone protects cortical neurons against LPS insult at least via inhibiting JNK activity and NO generation, but not PPARγ activation.

Objective To observe the effects of simultaneous bilateral central venous intubation on chest drainage for bilateral malignant pleural effusion induced by primary non-small lung cancer and summarize the nursing measures. Methods Totally 65 patients with bilateral malignant pleural effusion were randomized into experiment group and control group. In the former group, chest drainage was done using bilateral central venous intubation and in the latter, unilateral chest drainage was used. The two groups were compared in terms of effectiveness rate, time for intubation, remission duration and hospitalization. Results The time for remission duration, hospital stay and time for intubation were all significantly shorter than those of the control group (all P<0.05). There were no significances in curative effect and adverse reactions between the two groups. Conclusion Chest drainage using simultaneous bilateral intubation for bilateral malignant pleural effusion induced by primary non-small lung cancer can be effective in shortening the time for remission, intubation and hospitalization. But it causes no more adverse reaction.