OBJECTIVE:To investigate the value of genetic testing in clopidogrel individualized antiplatelet therapy for acute coronary syndrome(ACS)patients after percutaneous coronary intervention(PCI). METHODS:Clinical pharmacists participated in therapy for 3 ACS patients after PCI,and analyzed risk factors of stent thrombosis as the degree of lesion complexity,length and number of stents,complication,smoking history,etc. Clinical pharmacists suggested conducting clopidogrel genetic testing (CYP2C19,PON1,ACBC1),and suggested replacing antiplatelet agents,maintaining original plan and strengthening monitoring according to the results of genetic testing. RESULTS:The physicians adopted the suggestions of clinical pharmacists. After optimiz-ing antiplatelet therapy according to the results of genetic testing and clinical factors,3 patients were stable and discharged from hospital with drugs. CONCLUSIONS:Genetic testing can provide evidence for the formulation of individualized antiplatelet thera-py in ACS patients after PCI,and can be regarded as one of the breakthrough points for clinical pharmacists to carry out pharmaceu-tical care. In conducting genetic testing,clinical pharmacists should evaluate the risk of thrombosis in ACS patients and select the appropriate population for testing. At the same time,the clinical factors as medication compliance,stent thrombosis risk,therapeu-tic efficacy,ADR,and evidence-based pharmaceutical evidence should be comprehensively evaluated on the basis of genetic test-ing,and antiplatelet therapy plan should be optimized so as to guarantee the safety and effectiveness of drug use.

Objective To investigate the mechanism of Chinese herbal medicine compound Tang Mai Ping (TMP) capsule to type 2 diabet in rats. Methods The models of type 2 diabetic rats were established by injecting lower dosage of streptozotocin (STZ, 35 mg/kg) to belly, and fed high sucrose and high fat diet. Modle rats were randomly divided into model group, TMP group, and Erjiashuanggu (EJS) group, at the same time normal control. The content of plasma insulin was detected by radio-immunicy, mRNA expressing of frame muscle of Glucose Transporter 4 (GluT4) gene was detected with hyvirdism in situ. Results After built model, levels of insulin were obviously ascended in rats, but the expression of GluT4 mRNA lower significantly (P

Objective To evaluate the effects of tadalafil on chronic allograft vasculopathy. Method The abdominal aorta transplantation was performed on Male Lewis or Brown-Norwai rats as donors and male Male Lewis rats as recipients. The recipients were divided into 3 groups: Group A (Lewis-Lewis)with no treatment ;Group B (BN-Lewis) with no treatment; Group C (BN-Lewis) received tadalafil treatment (0.5 mg/kg per day). The rats were sacrificed at 8 weeks post treatment. The grafted aortas were used for histology and Western blot assay. Plasma cGMP level was detected by ELISA assay. Results The aortas intimal in group C was significantly thinner than that in group B. PKG-Ⅰprotein expression in group C was significantly higher than that in group B. Expression of RhoA in group C was lower than that in group B. Conclusion Tadalafil has positive effect on chronic allograft vasculopathy.

Objective To observe the effect of artificially construction of the life cycle of Angiostrongylus cantonensis in the laboratory condition so as to provide the basis for the research of angiostrongyliasis. Methods SD rats were infected orally with the third?stage larvae of A. cantonensis collected from infected Pomacea canaliculata. Six weeks after the infection the first?stage larvae were isolated and counted from fresh feces of the rats and then were used to infect P. canaliculata. Three weeks lat?er the snails were dissected for counting the third?staged larvae of A. cantonensis. Results The first?stage larvae were detect?ed in the feces of the rats 6 weeks after the infection and the third?staged larvae were successfully isolated after the infection of P. canaliculata. Conclusion The animal model of the entire life cycle of A. cantonensis is successfully established in the labo?ratory with the infection of 50 larvae per rat.

Aim To study the protection and possible mechanism of 5-hydroxy-1 H-indazole against 1-methyl-4-phenylpyridinium iodide ( MPP+)-induced SH-SY5 Y cell apoptosis. Methods An apoptotic model was es-tablished in human neuroblastoma SH-SY5 Y by MPP+in vitro. MTT analysis was used to evaluate the protec-tive effect of 5-hydroxy-1H-indazole. Immunochemistry and Hoechst33258 nuclear staining were used to ob-serve the neuroprotection and anti-apoptosis of 5-hy-droxy-1H-indazole. Western blot was used to detect the levels of P-tau ( Ser396 ) closely related to neuronal apoptosis and its upstream kinases:P-GSK-3β and CDK5 . Results MPP+ induced activation of GSK-3β, increase of activity of CDK5 , tau hyperphosphory-lation and neuronal cell apoptosis. However,5-hydrox-y-1 H-indazole reduced the activities of GSK-3β and CDK5,then decreased the level of tau hyperphosphory-lation and inhibited MPP+-induced SH-SY5 Y cells ap-optosis. Conclusions 5-hydroxy-1H-indazole could attenuate MPP+-induced SH-SY5 Y neuronal cell apop-tosis. Possible mechanism is that 5-hydroxy-1H-in-dazole inhibits GSK-3βand CDK5 two signal transduc-tion pathways to lower the level of tau phosphorylation, then plays a role of neuroprotection.

Objective To explore the factors related to the delayed graft function (DGF). Methods Clinical data of 150 recipients were collected and performed by Cox proportional hazards regression analysis . In addition, the glutathione S-transferase (GST) gene polymorphism of 172 donors and 157 healthy persons was analyzed by multiple PCR and SSP-PCR. Results DGF was observed in 24 patients among 150 recipients. Pretranplantation dialysis mode, PR A levels and recipient gender were uncorrelated with the incidence of DGF(P>0. 05). Urinary volume of the second 24 hours after transplantation was an independent predictor of DGF(RR=1. 002, P = 0. 001). The frequency of donor's null GSTM1 in DGF group was significantly higher than that in non-DGF group(P<0. 05). Conclusions Urinary volume of the second 24 hours after transplantation could be a predictor for DGF. The null GSTM1 in donor might be one of the factors related to the EGF.

An insight of the building and operation of the medical rescue and assurance system for Beijing Olympic Games will help identify effective practices for design and implementation of medical rescue plans in large-scale activities held in cities. Practice-proven: large-scale activities call for systems designed in view of characteristics of medical assurance tasks of such events, and such systems must be improved all the way. Keys to operations of Olympic venues in the run-up period are setup of medical services, development of general medical procedures, management of medical teams in venues, and design of medical rescue flows. Focuses of venue operations during the games are reporting of medical information from the venues, seamless interconnection between venues and medical organizations in the city, and crisis management for medical operations on the venues.

Objective To evaluate the value of diffusion weighted imaging (DWI)in distinguishing the solid solitary pulmonary nodule (SPN).Methods 42 patients with SPN (malignant in 25 and benign in 1 7)who were confirmed by operation,biopsy or follow up after treatment underwent routine chest T1 WI,T2 WI and DWI.The b values were chosen as 300,500,800 and 1 000 s/mm2 ,and the corresponding apparent diffusion coefficient (ADC)values and the signal intensity (SI)were respectively measured.Results The ADC values and SI of benign and malignant SPNs were gradually reduced with increasing b value.The ADC value between benign and malignant SPNs was statistically significant with b value of 500 s/mm2 (P 500 =0.03 <0.05 ),meanwhile the SI was statistically significant with b values from 300 to 1000 s/mm2 (P 300 <0.001,P 500 =0.03 <0.05,P 800 =0.01 <0.05, P 1 000 =0.02<0.05).Conclusion Both SI and ADC value of DWI play important role in distinguishing benign and malignant SPNs, and the diagnostic efficiency of SI is superior to ADC value.

Objective To compare minimally invasive percutaneous nephroscope and channel percutaneous nephroscope clinical curative effect for the treatment of kidney stones.Methods According to the digital table, 1 10 cases of patients with renal stones were selected and randomly divided into the control group 58 cases and obser-vation group of 52 cases.The control group underwent big channel percutaneous nephrolithotomy(PCNL),the observa-tion group were treated by minimally invasive percutaneous nephrolithotomy(MPCNL).Compared the two groups of patients with stone size,operation time,bleeding volume,decreased hemoglobin values before and after operation,and one-staged stone clearance rate.The changes of renal function in the two groups of patients before and after operation were analyed.Results The two groups with operation were completed successfully,no bleeding and other operation condition happened.The operation hemorrhage of the control group was (118.7 ±31.3)mL,the operation hemorrhage of observation group was (56.8 ±31.7)mL,there was a significant difference between the two groups (t=-10.192, P<0.05).In the control group,the stone size,operation time,operation decreased hemoglobinvalue and one-staged stone clearance rate were (19.2 ±4.8)mm,(115.8 ±44.7)min,(11.2 ±3.9)g/L,88.5%.In the observation group,the stone size,operation time,operation decreased hemoglobinvalue and one-staged stone clearance rate were (21.5 ±7.3)mm,(126.3 ±25.7)min,(56.8 ±31.7)g/L,78.1%.The two groups showed no significant differ-ences (P>0.05).Renal function of the two groups were not significantly changed before and after 4 weeks of opera-tion,the two groups showed no significant differences(P>0.05 ).Conclusion The curative effects of two kinds of operations are similar,but the amount of hemorrhage of minimally invasive nephrolithotomy is less.Two kinds of opera-tion methods had no significant effects on patients renal function.

BACKGROUND: A lot of researches have proved that polyglicolide acid (PGA), as a stent material, has been successfully used to construct engineered tissues, such as cartilage, bone and tendons, in nude mice or even big mammal. Whether the incubation of vascular endothelial cells and smooth muscle cells in the polyglicolide acid may subcutaneously construct vessel-like structure in nude mice needs a further study.OBJECTIVE: To verify the feasibility of forming vessel-like structure in the nude mice by subcutaneous implantation of polyglicolide acid cocultured with vascular endothelial cells and smooth muscle cells derived from newborn umbilical vein.DESIGN: Contrast study.SETTING: Tissue Engineering Key Laboratory, Medical College, Shanghai Jiao Tong University.MATERIALS: This study was performed at Tissue Engineering Key Laboratory, Medical College, Shanghai Jiao Tong University from January to June 2002. Belly band was derived from newborn babies in our department of obstetrics & gynecology. The parturien provided the informed consent, and this study was approved by the local research ethics committee. Twenty-six nude mice (3-4 weeks old, clean grade, irrespective of gender) were selected in this study. The animal experiment received confirmed consent from the local ethic committee. Polyglicolide acid was provided by Albany International Research Co.METHODS: Vascular endothelial cells and smooth muscle cells derived from newborn umbilical vein were incubated on a piece of polyglicolide acid to produce cell-material compound. In addition, the compound covered around the silicone tube to form a tube-like structural substance. Subsequently, the tube-like structural substance was subcutaneously implanted in 20 nude mice, which were regarded as an experimental group. And then, polyglicolide acid alone was subcutaneously transplanted in the rest 6 nude mice, which was regarded as a control group.MAIN OUTCOME MEASURES: Gross observations of cell-material compound by 2 and 6 weeks after transplantation;HE staining and immunohistochemical staining.detection; expression of factor Ⅷ and α-smooth muscle actin.RESULTS: Twenty-six nude mice were included in the final analysis. ① Gross observation: At 2 weeks after implantation,both the experimental and control groups formed tubular structures, however, at 6 weeks after implantation, the tubular structure still remained in experimental group but not in the controls. ② Histological observation and immunohistochemical detection: The histological examination of the engineered vessel showed that at 2 weeks, the vessels in both group contained mainly undegraded PGA fibers, while at 6 weeks, the PGA fibers were almost completely degraded in both groups and in the control group only fibrous-like tissue formed. Contrastly, in experimental group a typical vascular structure formed, Masson's trichrome stain, which stains collagen green, smooth muscle fibers red and cells purple, showed significant amounts of stainable collagen and smooth muscle fibers in the wall of the engineered vessel, furthermore,immunohistochemistry examination revealed that there were an endothelial cell layer formed in the inner surface of the engineered vessel which was confirmed by positive staining of yon Willebrand factor, meanwhile, the smooth muscle cells in the wall of the engineered vessel were confirmed by the positive staining of smooth muscle α-actin.CONCLUSION: The subcutaneous implantation of polyglicolide acid cocultured with vascular endothelial cells and smooth muscle cells may form vessels, which are similar to normal vascular histological structure.