OBJECTIVE:To observe the efficacy and safety of clopidogrel combined with aspirin in the treatment of transient ischemic attack in the elderly. METHODS:90 elderly patients with transient ischemic were randomly divided into observation group(50 cases)and control group(40 cases). All patients received conventional treatment,statins,low molecular weight dextran and urokinase,etc.,symptomatic treatment was conducted for patients combined with other underlying diseases. Based on it,con-trol group received 100 mg Aspirin enteric-coated tablet,once a day;observation group additionally received 75 mg Clopidogrel bi-sulfate tablet,once a day. No other antiplatelet drugs were allowed. They treatment for 6 months. Clinical efficacy,platelet func-tion indexes(CD63,CD62p)before and after treatment,recurrence rate and incidence of cerebral stroke after 6 months follow-up in 2 groups were observed,and the incidence of adverse reactions was recorded. RESULTS:The total effective rate in observation group was significantly higher than control group,recurrence rate and incidence of cerebral stroke were significantly lower than con-trol group,the differences were statistically significant(P<0.05). After treatment,CD63 and CD62p levels in 2 groups were sig-nificantly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05). And there were no obvious adverse reactions during treatment. CONCLUSIONS:Based on conventional treatment,clopido-grel combined with aspirin shows better efficacy than aspirin alone in the treatment of transient ischemic attack in the elderly,it can reduce the incidence of cerebral stroke and recurrence rate,with good safety.

BACKGROUND:It has been observed recently that tumor recurrence is closely related to cancer stem cel s. Cancer stem cel theory provides a new avenue for the study of gastric cancer pathogenesis, diagnosis and treatment. To determine the cel phenotype is helpful to target gastric cancer stem cel s, and contributes to exploring the self-renewal and differentiation of gastric cancer stem cel s, further providing new ideas for the treatment of gastric cancer. However, the phenotype of gastric cancer stem cel s remains controversial.
OBJECTIVE:To review the research progress in gastric cancer stem cel phenotype.
METHODS:A computer-based online search of PubMed database was performed to search related articles published between January 1965 and October 2015 with the key words of“Gastric Cancer Stem Cel s”in English. Sixty-eight articles were included for final analysis.
RESULTS AND CONCLUSION:Traditional cancer stem cel phenotypes are unsuitable for marking
gastric cancer stem cel s. Studies have found that CD90 expresses in primary gastric cancers, and cancer stem cel spheres would be required via serum-free culture by CD90 maker. CD24 expression can improve the adhesion, invasion and migration of gastric cancer cel s. Further studies have confirmed that a lot of cel s positive for both CD44 and CD54 can be found in patients with early recurrence of gastric cancer rather than those with advanced recurrence, and CD44 and CD54 expression in tumor cel s is likely to be an important cause of gastric cancer occurrence and recurrence. By analyzing the sorting, CD44+CD24+CD90+CD54+is likely to be the gastric cancer stem cel phenotype.

ObjectrueTo evaluate magnetic resonancec ho langiopancreatography (MRCP) in the diagnosis of acute or chronic pancreatitis . MethodsMRCP was undertaken in 30 patients with chronic and 9 with acute pancreatitis. Comparison was m ade with findings at ERCP.ResultsOf 196 segments of biliary-pancreatic duct analyzed, 17 were not seen at MR CP (sensitivity, 91%). Of the segments visualized at MRCP, 14 were incorrect ly characterized (accuracy, 92%). At MRCP, segments not detected or mischara cterized were either normal, slightly dilated, or narrowed. MRCP image quali ty was not interpretable in two cases due to artifacts. ConclusionVery good correlation between ERCP and MRCP findings was demonstrated. MRCP may substitude for ERCP, particularly in pa tients who cannot undergo ERCP or in whom ERCP has been unsuccessful.

BACKGROUND:Hematopoietic microenvironment regulates hematopoietic stem cel s mainly through the cel-cel , cel-soluble regulator and cel-extracel uar matrix modes. OBJECTIVE:To review the molecular mechanism underlying regulation of hematopoietic stem cel s under the cel-cel , cel-soluble factors and cel-extracel ular matrix modes. METHODS:A computer-based online search of PubMed database was performed to search related articles with the key words of“Niche, HSC, VCAM-1, VLA-4, TPO, MPL, ECM, Integrin, N-cadherin, ANG-1, Tie2, VLA-5, Jagged-1, Notch, CXCL12, CXCR4, SCF, Kit, BMPs/TGF-β, TGF-βR, IFNα, IFNαR”in English. Irrelevant or repetitive studies as wel as old literature were excluded, and final y 80 articles were included in result analysis. RESULTS AND CONCLUSION:Cel s on the endosteal surface, vascular endothelial cel s, perivascular cel s, and some unknown or certain cel s or smal molecules in the bone marrow cavity constitute the specialized microenvironment for hematopoietic stem cel s. Hematopoietic stem cel s in the hematopoietic microenvironment remain a relatively steady state, which is the result of mutual contact of hematopoietic stem cel s and hematopoietic microenvironment under the regulation of some important molecules, such as Pten and osteopontin, via the pathway between cel-intercel ular adhesions, intercel ular soluble factors, and cel s and extracel ular matrix.

Objective To compare the clinical curative effect of proximal femoral nail anti rotation ( PFNA) and dynamic hip screw fixation in the treatment of the femoral intertrochanteric fracture,and provide reference for the development of clinical surgery scheme.Methods 74 patients with femoral intertrochanteric fracture in our hospital were selected and randomly divided into observation group and control group,37 cases in each group.The control group was treated with dynamic hip screw fixation,and the observation group was treated with PFNA therapy.Opera-tive time,bleeding volume and wound healing were compared between the two groups.The time of bone healing and complications were compared between the two groups after operation 1,3,6 months, functional recovery of hip was evaluated after operation by Harris score in the two groups.Results Intraoperative bleeding in the observation group was (115.68 ±72.38)mL,the operation time was (43.26 ±11.47)min,which were significantly less than the con-trol group(t=9.62,7.11,all P<0.05).Bone healing time of the observation group was (11.82 ±1.37) weeks, which was significantly less than the control group(t=3.46,P<0.05).The incidence rate of postoperative complica-tions of the observation group was 8.11%,which of the control group was 13.51%,the difference was not statistically significant (P>0.05).1 month after surgery,the Harris score of the observation group was (71.39 ±4.38)points, which was significantly higher than the control group (t=3.17,P<0.05).Postoperative 3,6 months,Harris hip score had no statistically significant difference between the two groups ( all P >0.05 ) .Conclusion PFNA had less surgical trauma,early functional exercise for patients after surgery by comparison with dynamic screw fixation.It could promote fracture and hip joint function rehabilitation.

[Summary] Good glycemic control can delay the occurrence and development of diabetic complications. Artificial pancreas, which autonomously mimics the physiologic glucose control of pancreas islet, regulates the blood glucose subtly. Artificial pancreas seems to be one of the promising glucose control approaches.

With the progress of gastrointestinal stromal tumor(GIST), to prevent GIST's recurrence and metastasis is still a hot topic. The pre-operative pathological diagnosis of GIST is difficult to be made, and the biopsy has the chance to cause metastasis. Standard operative procedure is the key point to prevent GIST's recurrence and metastasis, which includes en-bloc resection, enough margin and so on. For the recurrence/metastasis GIST, the reoperation can be performed, but the effective therapy is to use the molecular targeted drug:imatinib.

The treatment of gastrointestinal stromal tumors (GIST) has been revolutionized by the molecular targeted therapy, but we still emphasize the importance of how to use surgical principle and skill to treat GIST. In this review, we describe the experience in the treatment of GIST located in esophagus, gastrointestinalinal tract and colorectum. During operation, the surgeon shouldi resect the tumor completely. If the tumor can not to be resected completely, treatment should be managed by imatinib mesylate(Gleevec). Because GISTs seldom appear lymph metastases, it is not necessary to perform lymph node dissection.

Abdominal imaging is one of the important clinical applications of magnetic resonance imagining, but image degradation due to respiratory motion remains a major problem. Retrospective respiratory navigator gating technique is an effective approach to alleviate such degradation but is subject to long scan time and low signal-to-noise ratio (SNR) efficiency. In this study, a modified retrospective navigator gating technique with variable over-sampling ratio acquisition and weighted average reconstruction algorithm is presented. Experiments in phantom and the imaging results of seven volunteers demonstrated that the proposed method provided an enhanced SNR and reduced ghost-to-image ratio compared to the conventional method. The proposed method can also be used to reduce imaging time while maintaining comparable image quality.
Algorithms ; Artifacts ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Motion ; Phantoms, Imaging ; Respiration ; Signal-To-Noise Ratio

Objective To explore the possibility of polymethyl methacrylate (PMMA) bone cement as the carrier for lipophilic drugs through in vitro cytotoxicity study and molecular modeling with PMMA and 17-allylamino-17-demethoxy-geldanamycin (17-AAG) loaded PMMA bone cement.Methods The 17-AAG loaded bone cement was made by mixing method.In vitro antitumor activity with MTT assay for PMMA,17-AAG,the 24 h and 48 h released solution of 17-AAG loaded PMMA bone cement were evaluated.Through Material Studio 5.0,the interaction between 17-AAG and PMMA through the model of Amorphous Cell and energy optimization of Forcite was explored.Results The inhibition ratio of MMA for tumor cells is 9.21％±0.06％ with 50 μmol/L.The 24 h released solution of 17-AAG loaded PMMA bone cement (17-AAG∶ PMMA=1∶ 4 000) inhibits the tumor cells 66.15％±0.43％ which has a quick released influence on 17-AAG.The inhibition of 24 h released solution of 17-AAG-loaded PMMA bone cement (17-AAG∶PMMA=1 ∶ 1 000,1∶2 000) shows no significance compared with PMMA released solution (P＜0.05).The 48 h released solution of 17-AAG-PMMA (17-AAG∶ PMMA=1∶ 1 000,1∶2 000,1∶4 000) inhibits U26630.25％±4.47％,30.24％±3.42％,50.52％±5.20％,with a significant difference with PMMA.The molecular model showed that the interaction between 17-AAG and PMMA was van der Waalz bonds,which drove 17-AAG inside or on the surface of PMMA bone cement.Conclusion PMMA bone cement can be used as a carrier for lipophilic drugs.It has antitumor activity and influences the release of 17-AAG with different ratio,for example it has a sustained-released influence on 17-AAG in 17-AAG-PMMA (17-AAG∶PMMA=1 ∶ 1 000,1∶2 000).Molecular model implies that 17-AAG exists inside or on the surface the PMMA bone cement through van der Waalz bonds.