Objective: To compare therapeutic effects of clopidogrel and loading dose ticagrelor on aged patients with ST elevation myocardial infarction (STEMI).Methods: A total of 160 aged STEMI patients undergoing emergency percutaneous coronary intervention (PCI) were selected.According to random number table, they were randomly and equally divided into clopidogrel group (received loading dose aspirin and clopidogrel therapy) and ticagrelor group (received loading dose aspirin and ticagrelor therapy).Coronary TIMI flow grade, incidence rate of no-reflow after PCI, and incidence of cardiac adverse events and bleeding events in one month after PCI were compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of coronary TIMI flow grade 3 (71.25% vs.90.00%), and significant reduction in incidence rate of no-reflow (28.75% vs.10.00%) in ticagrelor group,P<0.05 all.Compared with clopidogrel group on one month after PCI, there were significant reductions in incidence rates of cardiogenic death (13.75% vs.3.75%), in-stent thrombosis (6.25% vs.0) and recurrent myocardial infarction (10.00% vs.1.25%), but significant rise in incidence rate of dyspnea (3.75% vs.12.50%) in ticagrelor group, P<0.05 all.There was no significant difference in incidence of bleeding events between two groups, P>0.05 all.Conclusion: Loading dose ticagrelor can effectively improve coronary blood flow, reduce no-reflow and its safety is good in aged patients with ST elevation myocardial infarction, which is worth extending.

Kennedy disease,a motor neuron disease,is an adult onset form of spinal and bulbar amyotrophy characterized by the damage of low motor neuron and uncompleted androgen insensitivity syndrome.So far,there is no effective treatment.This article is intended to provide neurologist with information about Kennedy disease in epidemiology,etiology,pathogenesis,clinical feature,treatment and so on.

Objectives To analysis the main characteristics and changes of the internal death in pediatric intensive care unit (PICU) in the past five years. Methods The clinical data of 330 death cases in PICU internal medicine were retrospectively analyzed from January 2008 to December 2012. Results The mortality rate in PICU dropped from 5.85%to 3.96% from 2008 to 2012. Among 330 death cases, 136 cases (41.2%) were infants, 73 cases (22.1%) were toddlers, 51 cases (15.45%) were preschoolers, and 70 cases (21.21%) were school-age and adolescence. In different years, the differences of distribution of death in different age groups were statistical significance (χ2=6.90, P=0.009). In all years, the infant had the highest death rate. As the time progresses, the death rate of the infant and young children decreases, while the death rate of the school-age and adolescence increases. Among the diseases caused death, the cardiovascular disease was the most common disease (33.94%), followed by hematologic malignancy (31.52%). The difference of distribution of the diseases caused death in different age group was statistically significant (P<0.01). The cardiovascular disease was main cause of death in infant, and the hematologic malignancy was the main cause of death in other three age groups. Within 24 h admission, the pediatric critical illness score (PCIS) had been assessed, 67.49% was critical and 15.48%was extremely critical. The hospitalization time was negatively correlated with PCIS (r=-0.313, P<0.001). Conclusions In the past five years, the mortality in PICU declined year by year. Cardiovascular disease in infancy and hematologic malignancy in non infancy are the leading cause of death in children. Admission in critical or extremely critical condition is the reason of early death in hospital.

Objective: To observe the clinical efficacy of Xingnao-Kaiqiao acupuncture("醒脑开窍"针法) on patients with cerebral infarction.Methods: Sixty-three patients with the disease were randomly divided into treatment group(n=32) treated with Xingnao-Kaiqiao acupuncture and control group(n=31) with(traditional) acupuncture.In addition,routine medicine therapies were given to the two groups(including(dehydration),(decrease) of intracranial pressure,enhancement of nerve nutrition and supportive treatment).(Xingnao-)(Kaiqiao acupuncture) was used and adjusted the number of points with different syndromes in the treatment group,main points were as follows: Neiguan(内关PC6),(Rengzhong)(人中GV26),Sanyinjiao((三阴交)SP6) and vice points were Jiquan(极泉HT1),Chize ((尺泽LU5)),Weizhong(委中BL40),Fengchi(风池GB20),Yintang (印堂EX-HN3),Shangxing((上星DU23)-through-Baihui)(百会GV20).Traditional acupuncture was used in the control group.Points at the upper limbs were Jianjing(肩井GB 21),Quchi(曲池LI 11),Waiguan(外关(S)51),Hegu(合谷LI 4) and at the lower limbs were Zusanli(足三里ST36),Yanglingquan(阳陵泉GB34),Huantiao(环跳GB30),Fenglong(丰隆ST40),Kunlun(昆仑BL60) etc..Acupuncture was given twice a day for 15 days in both groups.Before and after therapy,the hemorrheology,blood lipid,blood,urine,stool and biochemical routine examinations,white blood cell (WBC) count in(peripheral) blood and neurological deficit score(NDS) were(determined).Curative effects of two groups after treatment were observed.Results: After treatment,the total effective power was 93.75% in the treatment group,while it was 67.74% in the control group,the difference being significant (?~2=4.85,P

Objective To definite the interactions between the human gastric carcinoma cell and the human vascular endothelial cell during the establishment and maintenance of the tumor vascular system and the tumor hematogenous metastasis.Methods We prepared the conditioned mediums of each cell so as to study the effect of the conditioned medium on itself or others by MTT colorimetry. The comprehensive effect of interactions between two cells was determined by stratified transfilter co-culture or direct contact co-culture.Results The conditioned medium of human gastric carcinoma cell can stimulate the proliferation of the human vascular endothelial cell, but the CM of HVEC can inhibit the growth of HGCC. Both kinds of cells can inhibit the growth of itself. The ultimate comprehensive effect of the interactions between two kinds of cells was increase of total cell numbers.Conclusion There exist the complicated interactions between the human gastric carcinoma cell and the human vascular endothelial cell during the tumor angiogenesis and the tumor hematogenous metastasis. The ultimate comprehensive effect of the interactions is increase of total cells numbers and tumor volume.

OBJECTIVETo explore the effect of combination of Epimedii Folium and Ligustri Lucidi Fructus on osteoporosis rats induced by retinoic acid.

METHODSixty three-month-old male Wistar rats were randomly divided into the normal control group, the model group, the Epimedii Folium group, the Ligustri Lucidi Fructus group, the combination group of Epimedii Folium and Ligustri Lucidi Fructus and the raloxifene group. The osteoporosis model was established through oral administration with retinoic acid for two weeks. Meanwhile, all of treatment groups were administered with corresponding drugs for three weeks. The contents of serum calcium (Ca), phosphorus (P), alkaline phosphatase (AKP) and tartrate-resistant acid phosphatase (StrACP) were detected, and the pathomorphological changes of femurs were observed.

RESULTThe model control group showed much lower contents of serum Ca and P than the normal control group, but with significantly higher AKP and StrACP activity than the normal control group. The femoral head area showed reduced, narrow and sparse trabecular bones, with typical osteoporosis-like changes. Compared with the model control group, all of treated groups showed significant increase in Ca and P contents in serum, and down-regulate AKP and StrACP levels, while trabecular bones became more and wider, and densely interweaved as a reticular formation. Among them, the combination group showed the most significant effect.

CONCLUSIONEpimedii Folium and Ligustri Lucidi Fructus could effectively correct the abnormal bone metabolism and improve pathological conditions of bone tissues, so as to show the anti-osteoporosis effect. The combined application of the two drugs showed a better efficacy.

Acid Phosphatase ; blood ; Alkaline Phosphatase ; blood ; Animals ; Body Weight ; drug effects ; Calcium ; blood ; Drug Interactions ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Epimedium ; chemistry ; Femur ; drug effects ; pathology ; Isoenzymes ; blood ; Ligustrum ; chemistry ; Male ; Osteoporosis ; blood ; chemically induced ; drug therapy ; pathology ; Phosphorus ; blood ; Rats ; Rats, Wistar ; Tartrate-Resistant Acid Phosphatase ; Tretinoin ; adverse effects

Objective To understand the extent and relative changes of equities in using the prenatal care services among premature delivery women from 4 counties/cities in Jiangsu and Zhejiang provinces, from 1995 to 2000. Methods The study population consisted of 97 537women who delivered singleton live birth of 28 to 41 gestational weeks in 4 counties/cities of Jiangsu and Zhejiang provinces, from 1995 to 2000. The proportions of women with early prenatal visit, of those with at least five prenatal visits and the hospital delivery rates between premature and term delivery groups were calculated. Inequalities in the above indictors by comparing rate difference ( RD), rate ratio ( RR ) and concentration index ( CI ) among women with different educational levels,were examined. Chi-square and One-way ANOVA were used to compare the differences. Results The proportions of having received early prenatal among those women with premature delivery in different education levels were 82.89%, 91.06%, 93.96%, 93.11% respectively, which were less than that of those with full term delivery (86.36%, 93.95%, 95.65%, 96.41%, P=0.008). The proportions of having received early prenatal among the women with high educational levels were higher (RD=-10.05, RR=0.90, CI=0.0104) than those with low educational attainment (RD=-10.22, RR=0.89, CI=0.0131); The proportions of having received at least five prenatal visits among those women with premature delivery in different education levels were 86.54%, 93.17%, 92.99%, 96.49%,respectively, which were less than those with full term delivery (94.60%, 96.65%, 96.15%, 96.66%,P=0.005). The proportions of having had at least five prenatal visits among the women with high educational attainment were higher (RD=-2.06, RR=0.98, CI=0.0006) than those with lower educational attainment (RD=-9.95, RR=0.90, CI=0.0077); The proportions of hospital delivery among the women with full term delivery in different education levels were significantly higher (99.45%, 99.75%, 99.83%, 99.77% ) than those with premature deliveries (98.42%, 99.54%, 99.61%,100.00%, P=0.005). The proportions of hospital delivery among women with high educational attainment was higher (RD =-0.32, CI= 0.0003 ) than those with lower educational attainment ( RD =-1.58, CI=0.0013). Conclusion Education related inequities in prenatal care utilization had not been improved among the Chinese women under our study. Inequities were seen in those women with full-term delivery the preterm delivery ones.

OBJECTIVE1,25-dihydroxyvitamin D3 [1,25(OH)2D3] is a potent inducer of differentiation in myeloid leukemia cells, but its clinical use is limited due to its hypercalcaemic effect and resistance. Carnosic acid is a plant-derived polyphenol food preservative with chemoprotective effects against carcinogens. Recent research has shown that carnosic acid potentiates the effects of 1,25(OH)2D3 on differentiation of human leukemia cells. This study examined the effects of 1,25(OH)2D3 in combination with carnosic acid on monocytic differentiation as well as intracellular reactive oxygen species (ROS) and Ca2+ levels in human leukemia HL-60 cells.

METHODSHL-60 cells were randomly treated with 1 nmol/L 1,25(OH)2D3, 100 nmol/L 1,25(OH)2D3, 10 micromol/L carnosic acid, a combination of 1 nmol/L 1,25(OH)2D3 and 10 micromol/L carnosic acid or placebo. Cell growth was observed by MTT assay for 72 hrs at an interval of 24 hrs. Cells were harvested after 72 hrs of culture. Morphologic features of the cells were observed by microscopy. Flow cytometry was used to detect cell cycle, monocytic differentiation marker CD14 expression, and intracellular ROS and Ca2+ levels.

RESULTSA combination of 1 nmol/L 1,25(OH)2D3 and 10 micromol/L carnosic acid resulted in greater proliferation inhibition (Ab: 0.56 0+/- 0.020 vs 1.482 +/- 0.327; P <0.01), mature monocytic features, G0 /G1 cell arrest, higher CD14 expression (57.62 +/- 0.817% vs 2.76 +/- 0.828%; P <0.01), lower intracellular ROS levels (52.67 +/- 10.76% vs 86.46 +/- 40.52%; P <0.01 and similar intracellular Ca2+ levels in HL-60 cells when compared with the placebo group. The ability of a combination of 1 nmol/L 1,25(OH)2D3 and 10 micromol/L carnosic acid to inhibit the proliferation and induce the differentiation of HL-60 cells was similar to that of 100 nmol/L 1,25(OH)2D3, while the intracellular Ca2+ level (115.64 +/- 17.74 nmol/L vs 185.75 +/- 27.38 nmol/L) was significantly lower than that in the 100 nmol/L 1,25(OH)2D3 group.

CONCLUSIONSLow concentration of 1,25(OH)2D3 combined with 10 micromol/L carnosic acid can produce enhanced differentiation, proliferation inhibition and antioxidant effects of HL-60 cells. The combination of the two inducers dose not increases intracellular Ca2+ levels.

Calcitriol ; pharmacology ; Calcium ; metabolism ; Cell Cycle ; drug effects ; Cell Differentiation ; drug effects ; Diterpenes, Abietane ; pharmacology ; HL-60 Cells ; Humans ; Lipopolysaccharide Receptors ; analysis ; Plant Extracts ; pharmacology

OBJECTIVETo investigate the clinical manifestations, genotypes, and genetic characteristics of two pedigrees with Kennedy disease.

METHODSThe clinical data of the patients from two Kennedy disease families were collected. The numbers of trinucleotide CAG repeats in exon 1 of the androgen receptor gene were determined by DNA sequencing and repeat fragment analysis.

RESULTSFamily A was composed of 58 individuals in 4 generations. The proband had onset at 39 years old. There were two Kennedy disease patients in family B which included 61 individuals in 5 generations. The two patients had onset at 39 and 41 years old, respectively. All the three patients displayed limbs and bulbar muscular weakness because of the damage of lower motor neurons. They had androgen insensitivity syndrome in common, and showed mild or moderate increase in serum creatine kinase level. The electromyogram showed wild damage in anterior horn of spinal cord. Muscle biopsy displayed neurogenic muscular atrophy. The numbers of the CAG repeat expansion in the androgen receptor gene of the three patients were 49, 48, and 47, respectively. X-linked recessive mode of inheritance was demonstrated by pedigree analysis in the two families.

CONCLUSIONKennedy disease usually occurs in mid-adulthood man. The clinical features are the weakness and wasting of limbs and bulbar muscles. Genetic analysis contributes to diagnosis and identification of carriers, and is beneficial to genetic counseling and prenatal diagnosis.

Adolescent ; Adult ; Aged ; Base Sequence ; Biopsy ; Bulbo-Spinal Atrophy, X-Linked ; diagnosis ; diagnostic imaging ; genetics ; pathology ; Child ; Child, Preschool ; Electromyography ; Exons ; genetics ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Muscles ; pathology ; Pedigree ; Receptors, Androgen ; genetics ; Ultrasonography ; Young Adult

Objective To investigate the effect of laser artificial shrinkage(LAS)on pregnancy outcome in vitrification of human expanded blastocysts.Methods We selected 3859 frozen-thawed blastocyst-stage embryo transfers from January 2014 to December 2015.The transfers were divided into LAS group(n=3 176)and non-LAS group(n=683),which were then subdivided into ＜36 y subgroup and ≥36 y subgroup according to their age.Main outcomes measures were thawing rate,implantation rate and clinical pregnancy rate.Results Thawing rate, clinical pregnancy rate and implantation rate were 97.32%(5 453/5 603),66.81%(2 118/3 170),and 53.55%(2 912/5 438)in LAS group.In non-shrink group,they were 95.13%(1 173/1 233),62.70%(427/681),and 49.74%(582/1 170),which did not significantly differ from those in the former group(P＜0.05).Further analysis of the subgroups showed that thawing rate was significantly higher in LAS group than in non-shrink group of patients＜36 y(97.27% vs.95.33%;P＜0.05).Thawing rate and biochemical pregnancy rate were significantly higher in LAS group than in non-shrink group in patients ≥36 y(97.75% vs.93.66%;65.45% vs.50.65%,P＜0.05). Cancellation rate was not significantly different between the two groups(0.19% vs.0.29%, P ＞ 0.05). Conclusion LAS technique can increase thawing rate,clinical pregnancy rate and implantation rate before cryopreservation of blastocysts.