Through occupying binding site of glycoprotein IIb/IIIa receptor,platelet glycoprotein IIb/IIIa inhibitor (GPI)inhibit the combination of fibrinogen and the receptor,then inhibit platelet aggregation.GPI is the most powerful anti-platelet drug and possesses application value in ACS now.This article made an overview on the newest research progress of safety and effectiveness of GPI in ACS.

[Objective] To investigate all-inside techniques for repairing lateral meniscus anterior horn tear with cysts.[Methods]Nineteen patiants with lateral meniscus anterior horn tear with cysts were collected from August 2006 to May 2008 with 7 males and 12 females.Five cases of isolated memberane cysts and 14 of lateral meniscus anterior horn tear with cysts were analyzed by MRI.Fifteen cases of lateral meniscus anterior horn tear with cysts and 4 of isolated memberanes cysts were finally diagnozed by arthoscopy.The apparatus of shoulder arthoscopy to sutured lateral injuried meniscus anterior horn were used after sheared cysts.Lysholm scores before and after operation were compared.Re-arthoscopy evaluation was performed for 13 patients.[Results]No case had complication after operation during short-term follow-up.Preoperative Lysholm scores was(64?5)points,postoperative scores was(94?7)ponits.Lysholm scores had significance between preoperation and postoperation(P

AIM:To investigate the pathologic role of aldosterone and protective effect of aldosterone receptor antagonist on peritoneal fibrosis in peritoneal dialysis rats .METHODS:A peritoneal fibrosis rat model was established by intraperitoneal injection of lipopolysaccharide ( at 1 d, 3 d, 5 d and 7 d, 0.6 mg/kg) and dialysate ( daily intraperitoneal injection of 4.25%dialysate, 100 mL/kg).At the same time, spironolactone (an aldosterone receptor antagonist , 100 mg? kg -1? d-1 ) was given to the model rats .After 4 weeks, the expression of aldosterone synthase CYP 11B2, 11β-hydrox-ysteroid dehydrogenase type 2 (11β-HSD2), mineralocorticoid receptor (MCR), and inflammatory factors were detected by immunohistochemistry , real-time PCR and Western blotting .RESULTS:The rat model of peritoneal fibrosis was suc-cessfully established .At the same time, the injury of mesothelial cells , deposition of collagen fibers and thickness of perito-neal were increased .Moreover , the infiltration of macrophages in the peritoneum/dialysate was increased .The level of al-dosterone and the expression of MCR , 11β-HSD2 and CYP11B2 in fibrotic peritoneum were obviously up-regulated as com-pared with normal rats .The expression of NF-κB/MCP-1 was also increased .However , treatment with spironolactone alle-viated peritoneal fibrosis and reduced the expression of NF-κB/MCP-1.CONCLUSION:Local aldosterone is involved in the process of peritoneal fibrosis via NF-κB/MCP-1 pathway.Spironolactone alleviates peritoneal fibrosis of peritoneal dial-ysis.

OBJECTIVE:To compare clinical efficacy of bivalirudin vs. tirofiban combined with heparin in the treatment of acute ST elevation myocardial infarction (STEMI) complicated with diabetes mellitus (DM). METHODS:195 patients diagnosed as STEMI complicated with DM were selected for retrospective study,and divided into bivalirudin group(100 cases)and tirofiban group(95 cases)according to the different treatment plan. All patients received emergency PCI within 12 hours and conventionally took aspirin and clopidogrel before and after PCI. Bivalirudin group was given bivalirudin 0.75 mg/kg intravenously before PCI, and continuous intravenous dripping of 1.75 mg/(kg·h)till the end of operation. Tirofiban group was given heparin 100 U/kg and ti-rofiban 10 μg/kg intravenously before PCI,and continuous intravenous dripping of 0.75 μg/(kg·h)tirofiban for 36 h. Postoperative reperfusion indexes,UCG monitoring indexes and safety were compared between 2 groups,and the content of serum BNP were compared before and after treatment. RESULTS:For the TIMI grade,TIMI frame count,the peak of CK-MB and peak time,ST segment decline percentage immediately after PCI,contents of serum BNP,LVEF,LVESD,LVEDD 7,30 d after treatment,the differences were not statistically significant between 2 groups (P>0.05). The incidence of MACE events was 36.8% in tirofiban group and 41.0% in bivalirudin group,there was no statistical significance between 2 groups(P>0.05). The incidence of bleeding events was 24.2% in tirofiban group and 7.0% in bivalirudin group,the difference was statistically significant (P<0.05). CON-CLUSIONS:Bivalirudin and tirofiban combining with heparin have same efficacy in the treatment of STEMI complicated with DM,while bivalirudin may significantly reduce the incidence of bleeding events during primary PCI.

Kazakh of Xinjiang is the region with a high incidence of esophageal cancer,genetic research is quite active in recent years.Through the research on biological activity of P53,RB gene during esophageal cancer process.We tried to find potential differences in the national heredity susceptibility and so to support treatment and the research.

Objective To analyze the curative effects of different managements of different types of fracture of the first metacarpal basal body. Methods From October 1984 to October 2003, 142 patients with fracture of the first metacarpal basal body were treated with 5 different methods: manipulative reduction and fixation with abduction tooth arch, manipulative reduction and suspension traction, manipulative reduction and fixation with abduction frame, manipulative reduction and percutaneous internal fixation with Kirschner wire, as well as open reduction and internal fixation with Kirschner wire or screw. Results 80 patients were followed up. The therapeutic efficacy was excellent in 65 cases , good in 13 cases, poor in 2 cases. Conclusion Different types of fracture of the first metacarpal basal body can be treated satisfactorily if a suitable management is applied accordingly.

OBJECTIVETo compare the efficacy difference in the treatment of senile insomnia among western, medication, acupuncture and the integrated therapy of acupuncture and western medication.

METHODSNinety-eight patients of senile insomnia were randomized into a western medication group (30 cases), an acupuncture group (35 cases) and an integrated acupuncture and medication group (35 cases). In the western medication group, estazolam 1mg was prescribed, taken 30 min before going to bed, oryzanol 20 mg, oral administration, three times a day, for 4 weeks totally. In the acupuncture group, the simple acupuncture therapy was applied at Shenmen (HT 7), Sanyinjiao (SP 6), Anmian (Extra), Baihui (GV 20) and Sishencong (EX-HN 1), as well as the supplementary points selected according to the differentiation. The acupuncture treatment was given once a day, 5 treatments a week, for 4 weeks totally. In the integrated acupuncture and medication group, the western medication was combined with acupuncture. The dosage and usage of western medication were same as those in the western medication group; and acupoints in acupuncture treatment were same as those in the acupuncture group. The treatment lasted for 4 weeks in the three groups. Pittsburgh sleep quality index (PSQI) and clinical efficacy were observed before treatment, after 4 weeks' treatment and in 4 weeks after discontinuity of treatment in the three groups.

RESULTSFour weeks after treatment, the clinical curative rates were 3. 3% (1/30), 21. 2% (7/33) and 25. 7% (9/35) in the western medication group, the acupuncture group and the integrated acupuncture and medicines group separately. The total effective rates were 70. 0%(21/30), 93. 9%(31/33) and 97. 1%(34/35) in the three groups separately. The curative rates and the total effective rates in the integrated acupuncture and medication group and the acupuncture group were higher than those in the western medication group separately (all, P<0. 01). PSQI scores after 4 Weeks' treatment were all improved as compared with those before treatment in the three groups (all P<0. 05). PSQI score in either the integrated acupuncture and medication group or the acupuncture group was lower than that in the western medication group, indicating the significant difference (both P< 0. 05). Four weeks after discontinuity of treatment, the efficacy was stable in the acupuncture group and the integrated acupuncture and medication group. PSQI score did not change as compared with that in the 4th week of treatment. The score in the western medication group ran back, close to that before treatment (P>0. 05). During the treatment, a few patients had dry mouth in the western medication group. The adverse reactions were not discovered in the other two groups.

CONCLUSIONThe integrated therapy of acupuncture and medication achieves the quick efficacy on senile insomnia and rapidly relieves the symptoms, with quite high clinical curative rate and total effective rate obtained. The long-term efficacy is better than that of western medication. The integrated therapy is the first option among the three therapeutic programs.

Acupuncture Points ; Acupuncture Therapy ; Administration, Oral ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Estazolam ; administration & dosage ; Female ; Humans ; Male ; Phenylpropionates ; administration & dosage ; Sleep Initiation and Maintenance Disorders ; drug therapy ; therapy ; Treatment Outcome

Objective To investigate a simple effective way to salvage failure of lateral retinacular release. Methods From March 2007 to May 2009,there were 23 knees of 23 cases for failure after lateral retinacular. All the patients had patellofemoral joint malatignment in some extend,whose patellofemoral joint CT scanned in dynamic. Before curing,the index of patellar tilting angle (PTA) was 19.6° ±5.7° , congruence angle(CA) was 23.6° ± 12.5° , patellar femoral index(PFI)was 2.7 ± 0.8, and hospital special score (HSS) knee score was (74.0 ± 9.2) points,then put on elastic knee sleeves for arranging the malalignment of patellofemoral joints, coincidentally, rehabilitation of vastus medians administered. Results All the patients were followed up for 6 - 26 (11.0 ± 2.3 ) months, 22 cases of 24 knees gained the excellent or good results,1 case had to experience surgery again. After curing, PTA was 11.2° ±3.7°,CA was 6.4° ±7.8°, and PFI was 1.1 ±0.3,escalated HSS knee score was (87.0 ±6.5) points, in these excellent or good patellofemoral joints. Significant difference showed apparently in the cohort through curing (P <0.05). Conclusion Administering elastic knee sleeves along with correct rehabilitation is a simple effective no-incisive cure for salvaging failure of lateral retinacular release.

To investigate and analysis the multiple medical adverse events about disposable umbilical cord clamp during clinical using in Zhejiang province, and put forward some opinions some suggestions to improve the processing technology, to strengthen the professional training of medical staff in medical institutions of umbilical cord clamp using, and to take precautions against more adverse events.
Disposable Equipment ; Humans ; Product Surveillance, Postmarketing ; Umbilical Cord

Background Retinal vascular caliber changes can reflect the development status of cardiovascular disease and diabetes-associated vascular diseases,so it is very important to quantitatively measure retinal vascular caliber in the study of systemic diseases and retinal vascular disease.However,the methodology study is rately seen in China within our knowledge.Objective The present study was to investigate the repeatability and reproducibility of IVAN software in measuring retinal vascular caliber.Methods This study was approved by Ethic Committee of Affiliated Hospital of Inner Mongolia Medical University,and written informed consent was obtained from each subject prior to medical examination.A prospectively diagnostic trail was performed.The digitized fundus color photograph centered on the disc from 192 eyes of 96 healthy volunteers were collected in Affiliated Hospital of Inner Mongolia Medical University from January,2013 to December,2014,and central retinal arteriolar equivalent (CRAE),central retinal venular equivalent (CRVE) and arteriovenous ratio (AVR) were analyzed by IVAN measurement software.The repeatability and reproducibility of IVAN software for random repeat measurement of retinal vessel caliber from consecutive 85 right eyes of 85 volunteers were evaluation by interobserver and intraobserver measurement with interclass correlation coefficient (ICC).The correlations of measuring results between two observers or two-time measuring were analyzed with Pearson linear correlation analysis.Bland-Altman agreeement analysis was employed to assess the agreeement of the outcomes.Results No significant differences were found in CRAE,CRVE and AVR between the right eyes and the left eyes (t=-1.009,1.090,-1.259,all at P＞0.05).The CRAE,CRVE and AVR values from observer 1 were (145.02±12.94) μm,(400.72±9.12) μm and 0.36±0.03,and those from observer 2 were (145.10 ± 11.86) μm,(401.17 ± 9.85) μm and 0.36 ± 0..03,with no significant differences between observer 1 and observer 2 (t =-0.074,-0.913,0.116,all at P＞0.05).The repeat CRAE,CRVE and AVR values from observer 1 were (145.02 ± 12.94) μm,(400.72 ±9.12) μm and 0.36 ±0.03,which were significantly different from the initial values (t =-0.777,-0.048,-0.745,all at P＞0.05).In two-time measurements of intraobserver,all ICC were ≥0.738 and showed good correlations (all at r≥0.739).The two measurements of interobserver,showed good correlations (r≥ 0.662),with all ICC ≥ 0.657.Bland-Altman plots showed good agreements in CRAE and CRVE measurement with 95％ limits of agreement(LoA) ranged from-18.5 μm to 17.3 μm and-9.8 μm to 9.6 μm in intraobserver,and from-19.3 μm to 20.0 μm and-10.2 μm to 9.0 μm in interobserver,respectively.Conclusions IVAN measurement software yields good repeatability and reproducibility in the quantitative measurement of retinal vascular caliber.