Objective To detect clopidogrel effect with light transmission aggregometry (LTA)and flow cytometry (FC). Methods ①Venous blood samples were taken from 71 inpatient with acute corotary syndrome (ACS)in PLA General Hos-pital,including unstable anqina,ST segment elevation myocardial infarction and non ST segment elevation myocardial infarc-tion (46 males,25 females)by random number table from June 2011 to March 2012,whose average age was 69(57~92).②All of them were served 160 mg aspirin and 300 mg clopidogrel after they were in hospital in the beginning,and then served with 75 mg/d clopidogrel for 6 months.On some day,firstly,they were required withdrawing drug for 10 days,and then ve-nous blood samples were separately taken from them before their served-clopidogrel again and their severd-clopidogrel 2 hours later.③The samples were assayed with LTA and FC simultaneously and the platelet aggregation rates before served-clopidogrel (ADPLTA-before serving ),platelet aggregation rates after served-clopidogrel (ADPLTA-after serving ),inhibition rates (ADPLTA-INDU ),PAC-1 activity percentage before served-clopidogrel (PAC-1 before serving ),PAC-1 activity percentage after served-clopidogrel (PAC-1 after serving ),inhibition rates (PAC-1 INHI ),CD62p activity percentage before served-clopidogrel (CD62pbefore serving ),CD62pactivity percentage after served-clopidogrel (CD62pafter serving ),inhibition rates (CD62pINHI )weregotten.All volunteers were signed informed consents and the experiment was approved by the hospital ethics committee.Re-sults ①The paired samples t-test was (t=-2.082,P =0.041)between ADPLTA-before serving (0%~97%)and ADPLTA-after serving (12%~97%),the paired samples t-test was (t = 3.663,P < 0.01)between PAC-1 before serving (15.1% ~ 78.9%)and PAC-1 after serving (14.5% ~ 78.3%);the paired samples t-test was (t = 2.082 and P = 0.041)between CD62pbefore serving (1.5% ~80.8%)and CD62pafter serving (1.4%~41.4%).②The pearson coeffcient correlation results were:ADPLTA-INDU (0%~28.2%) and PAC-1 INHI (0.6%~ 9.1%)(r = 0.297,P = 0.012);ADPLTA-INDU (0% ~ 28.2%)and CD62pINHI (0.1% ~ 48.5%)(r =0.220,P =0.065);PAC-1 INHI (0.6%~9.1%)and CD62pINHI (0.1%~48.5%)(r=0.736,P <0.001).Conclusion Because the correlation was bad between the inhibition rates of clopidogrel detected by FC and them by LTA,FC didn’t apply to clin-ical routine examination of the platelet aggregation.But it could be used to scientific researchs and auxiliary confirmation of routine examination results.

Objective: To optimize the extraction process of volatile oil from Fructus Litseae.Methods: Supercritical CO2 extraction (SFE-CO2) was used to extract volatile oil from Fructus Litseae, and the extraction process was optimized by a central composite design-response surface method (CCD-RSM).The kind and content of volatile oil extracted by SFE-CO2 and steam distillation (SD) were detected by gas chromatography-mass spectrometer (GC-MS).Results: The highest extraction rate of the total effective constituents was 66.26% when the optimum conditions were as follows: the extraction temperature was 44 ℃, the extraction pressure was 26 MPa, entrainer ethanol was 11 ml and the extraction time was 40 min.It was revealed that neral, geranial and limonene were the major constituents.Compared with that of SD, the kind of volatile oil extracted by SFE-CO2 was fewer while the content of citral extracted by SFE-CO2 was higher.Conclusion: The extraction process optimized by CCD-RSM provides reference for the extraction method and quality control of volatile oil from Fructus Litseae.

Objective To investigate the predictive value of CHADS2 and CHA2DS2-VASc score in left atrial (LA) or left atrial appendage (LAA) thrombus in patients with non-valvular atrial fibrillation (AF). Methods A total of 164 consecu?tive non-valvular AF patients confirmed by transesophageal echocardiography (TEE) were included in this study, and were divided into two groups, LA/LAA thrombus group and non LA/LAA thrombus group. The previous history was recorded in two groups of patients. Their CHADS2 and CHA2DS2-VASC scores were calculated based on the general data of two groups. The laboratory examinations and TEE indexes were compared between two gropes. Results Of all patients, the rate of LA/LAA thrombus was 19.5%. The CHADS2 and CHA2DS2-VASC scores were significantly higher in LA/LAA thrombus group than those of non LA/LAA thrombus group (2.1±1.3 vs 1.0±0.9, 3.4±1.8 vs 1.9±1.4,P<0.01). There were 13(11.9%) and 5 (8.8%) patients showed LA/LAA thrombus under low-moderate risk in the two score systems, respectively. Multivariate logis?tic regression analysis showed that CHADS2 score≥2 points(OR=3.735, 95%CI:1.508-9.251, P=0.004) and CHA2DS2-VASc score ≥2 points (OR=5.104, 95%CI:1.586-16.425, P=0.006) were independent risk factors of LA/LAA thrombus. ROC curve showed that AUC of CHADS2 and CHA2DS2-VASc scores to predict LA/LAA thrombus were 0.731 (95%CI:0.630-0.832, P<0.001) and 0.742 (95%CI:0.640-0.843, P<0.001), respectively. Conclusion CHADS2 and CHA2DS2-VASC score ≥2 points are independent risk factors of LA/LAA thrombus in patients with non-valvular atrial fibrillation. The pre?dictive values of both score systems are moderate. There are also LA/LAA thrombus in low-moderate risk patients when us?ing the two score systems, and with the increased risk stratification, the rate of LA/LAA thrombus is increased.

Objective An incentive system was established to promote the rapid development of scientific research and to improve the scientific management ability.Methods The research incentive system, which including research awards, research fund management, research fund matching, and performance management, was implemented in our hospital, aimed to develop a clear quantitative assessment index to encourage research activity, and maximize the research outcome.Results It is clear that the research project application and output in output have been increased;and it positively associated with the number of years of implementation with the statistical significance.Conclusions Establishment of the research incentive system has encouraged the clinicians to make effort to conduct research projects which has largely increased the number of research projects and produced better outcomes.Applying such system has enhanced the capacity of core research of the hospital.

Objective To study the clinical application value of microsurgery in treatment of tentorium meningioma.Methods 53 patients with tentorium meningioma were chosen,they all underwent microsurgical treatment,the extent of resection of the tentorium meningioma and treatment efficacy were observed.The mortality,causes of death of tentorium meningioma patients after microsurgery were analyzed.Spitzer index was compared before and after treatment,the life quality of the patients was evaluated.Results There was no death after microsurgical treatment.The tentorium meningioma tumor removal rate was huge tumor ＜ tumors ＜ medium-sized tumors ＜ small tumor.There were 9 cases excellent,14 cases good in Spitzer index before treatment,26 cases excellent,14 cases good after treatment,there was significant difference between them (x2 =19.15,P ＜ 0.01).Conclusion Microsurgical treatment for the patients with tentorium meningioma has better clinical efficacy and can greatly improve patients' quality of life,which is worthy of further clinical research and promotion.

Objective:To observe the effect of icariin on the osteoporosis of the ovariectomized rats,and to explore the mechanism.Methods:Fifty female rats aged 6 months were randomly divided into sham operation group, model group,positive drug group,low dose of icariin group and high dose of icariin group (n= 10).The rats in positive drug group were given with 1 mg· kg-1 nilestriol every week;the rats in low and high doses of icariin groups were given with 50 and 100 mg · kg-1 icariin every day.The bilateral ovaries of rats were excised by operation to establish the osteoporosis models.2 weeks after operation,the rats were treated with icariin for 12 weeks,and then they were sacrificed by drawing blood from abdominal aorta under anesthesia condion.The bone mineral density (BMD),serum biochemical indicators,bone histomorphology and the expressions of apoptosis-related proteins were detected.Results:Compared with sham operation group,the BMD of the rats in model group was decreased (P <0.01),the serum calcium level was decreased (P <0.05),and the serum phosphorus level was increased (P <0.05),and the serum BGP,ALP,NO and NOS levels were significantly decreased (P <0.05 or P <0.01).Compared with model group,the BMD of the rats in positive drug group and high dose of icariin group were obviously increased (P < 0.01 ), the serum calcium levels were increased, the phosphorus levels were decreased (P <0.05),and the BGP and ALP levels were increased significantly (P < 0.05 ). Compared with control group,the cortical in model group was thinned,the width of bone trabecula was reduced,the Bax and Caspase-3 expression levels in bone tissue were increased,and the Bcl-2 expression level was decreased.Compared with model group,the cortical in icariin group was thicked,the width of bone trabecula was increased,the Bax and Caspase-3 expression levels were decreased,and the Bcl-2 expression level was increased (P <0.05 or P <0.01). Conclusion:Icariin can protect the osteoporosis of ovariectomized rats,the function may be related to the inhibition of apoptosis.

Objective To explore the status of job burnout of medical staffs in minority border areas. Methods A total of 906 medical personnel from Pu'er hospitals in Yunnan Province were as-sessed with Maslach Burnout Inventory General Survey (MBI-GS) by t test, descriptive statistics, chi-square test, ANOVA and LSD-t pairwise comparison. Results ①The emotional exhaustion, cynicism and reduced personal accomplishment of medical staffs in minority border areas (1.55±1.40, 0.99± 1.29, 2.47±1.98) are significantly lower than general areas (P=0.000, 0.010, 0.000); ②emotional ex-haustion, cynicism and Maslach Burnout Inventory (MBI) total points of different levels of hospital medi-cal staff, the score of which in descending order are:municipal, county and township (town) levels (P=0.000, 0.000, 0.000); ③Female medical personnel's emotional exhaustion and cynicism are scored significantly higher than males medical staff (P=0.000, 0.025); ④The scores of emotional exhaustion, cynicism, reduced personal accomplishment and MBI total points of Bachelor medical staff are signifi-cantly higher than those of colleges as well as secondary schools and below (P=0.000, 0.000, 0.000, 0.012); ⑤The scores of reduced personal achievement of Lahu medical staff are higher than those of other ethnic groups (P=0.009). Conclusion In medical staffs in minority border areas there exists a certain extent of job burnout, which presents differences among genders, educational background, hos-pitals and ethnic groups.

Objective To determine the prognostic significance of non-thyroidal illness syndrome(NTIS) and FT3 on long-term all-cause and cardiovascular mortality in patients with coronary artery disease(CAD).Methods A total of 1 354 patients underwent coronary angiograhy and participated in the study.After screening,984 patients with CAD were enrolled finally and divided into NTIS group and euthyroid group.The admitted patients were also classified into Tertile 1-3 groups based on FT3 value.The relationship of long-term all-cause and cardiovascular mortality with FT3 was investigated by multivariate Cox regression analysis.Results 129 out of 984 patients had NTIS.As FT3 value decreased,both long-term all-cause mortality (Tertile 1 group 9.6％,Tertile 2 group 11.5％,Tertile 3 group 20.9％,P＜0.01) and cardiovascular mortality (Tertile 1 group 4.5 ％,Tertile 2 group 7.2％,Tertile 3 group 11.0％,P＜0.01) gradually increased.After adjusting for all factors,FT3 (HR =0.614,95％ CI 0.439-0.859)was independently associated with long-term all-cause mortality.FT3 (HR =0.605,95％ CI 0.370-0.986)was also a risk factor for cardiovascular mortality.Conclusion NTIS exists in patients with CAD without myocardial infarction.FT3 reduction is an independent risk factor for long-term all-cause and cardiovascular mortality in patients with CAD.

Objective To summary the experience of surgical types selection of chronic suppurative otitis media tympano‐plasty and evaluate its clinical curative effect .Methods Chronic suppurative otitis media patient records were collected ,surgical types selection based on hearing ,otoscope and mastoid CT selection .Finally 161 chronic suppurative otitis media patients (164 ears) whoes medical records and follow‐up of contents were complete were collected ,in which type Ⅰ tympanoplasty group with 40 ears , intact bridge radical mastoidectomy+ type Ⅰ tympanoplasty group with 30 ears ,and open radical mastoidectomy+type Ⅱ tympan‐oplasty group with 94 ears .The therapeutic effects of the three surgical methods for the treatment of chronic suppurative otitis media were evaluated from hearing ,quality of life as well as satisfactory score after surgery .Results The mean values of the air conductive hearing thresholds after operation in the three tympanoplasty groups were decreased than those before operation (all P<0 .05) ,while the mean values of the bone conductive hearing thresholds after operation showed no obvious changes (all P>0 .05) .There were no statistically significant improvements in the air conductive hearing thresholds in the three tympanoplasty groups (P>0 .05) .The improvements in patient′s subjective hearing of the there surgical methods were 82 .5% ,70 .0% and 83 .0%respectively ,there was no statistically significant (P>0 .05) .The improvements in the overall quality of life of the three surgical methods were 80 .0% ,80 .0% and 79 .8% respectively ,showed no statistically significant differences (P>0 .05);the reduction rate of patient′s worry about illness were 90 .0% ,93 .3% and 95 .7% ,showed no statistically significant differences (P>0 .05);the bas‐ic satisfaction rates in the postoperative satisfaction ratings of the three surgical methods were 100 .0% ,100 .0% and 97 .9% ,and there were no statistically significant differences (P>0 .05) .Conclusion For tympanoplasty in chronic suppurative otitis media pa‐tients ,surgical types selection based on hearing ,otoscope ,mastoid CT selection and intraoperative findings .From the evaluation of postoperative patients with hearing and quality of life ,three surgical methods of chronic suppurative otitis media Tympanoplasty a‐chieve satisfactory results .

ABSTRACT:To understand the status of contamination and antimicrobial resistance of Staphylococcus aureus (S .aureus) isolated from raw cow milk ,600 samples were collected from five different provinces in China .After isolation and identification of S .aureus from these samples ,157 S .aureus isolates were obtained .Furthermore ,their resistant phenotype and resistant gene were analyzed by MIC detection ,as well as nine drug‐resistance genes determination and analysis .The result revealed that most of the S .aureus isolates contained multiple antibiotic resistant genes ,and all of the isolates were resistant to penicillin . Of 98 .73% isolates were resistant to amoxicillin .Conversely ,all of the isolates were sensitive to enrofloxacin and vancomycin . Moreover ,there were 29 MRSA positive strains among which 22 strains carrying femA gene .In conclusion ,much more atten‐tion should be paid to the drug‐resistance capabilities of field S .aureus isolates in raw cow milk ,and further monitoring of drug resistant S .aureus strains in milk should also be strengthened so as to ensure milk safety .