Objective To investigate the risk factors for clopidogrel resistance (CR) in patients with ischemic stroke.Methods Turbidimatry was used to measure the platelet aggregation rate changes after the patients with acute ischemic stroke taking 75 mg of clopidogrel per day for 10-14 days.The patients were divided into either a CR or a clopidogrel sensitivity (CS) group according to the platelet aggregation rate changes.The demographic and clinical data of both groups were compared.Multivariate logistic regression analysis was used to identify the independent risk factors for CR.Results A total of 147 patients with acute ischemic stroke were included,42 of them (28.57％ ) were in the RC group and 105 (71.43％) were in the CS group.The proportion of patients in diabetes (54.76％ vs.11.43％ ;x2 =31.054,P =0.000),the history of transient ischemic attack (TIA) (80.95％ vs.26.67％ ;x2 =36.251,P=0.000) or percutaneous coronary intervention (PCI) (26.19％ vs.3.81％;x2 =16.400,P=0.000),taking calcium channel blocker (CCB) (83.33％ vs.54.29％ ;x2 =10.810,P =0.001 ),angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) (66.67％ vs.42.86％;x2 =6.803,P=0.009),and proton pump inhibitor (47.62％ vs. 14.29％;x2 =18.375,P =0.000) in the CR group,as well as the levels of plasma total cholesterol (TC),glucose,and glycated hemoglobin were significantly higher than those in the CS group.Multivariate logistic regression analysis showed that diabetes (odds ratio [ OR] 13.711,95％ confidence interval [ CI] 1.667 - 112.784; P =0.015),increased TC level (OR 2.828,95％CI 1.574 - 5.080; P =0.001),previous history of TIA (OR16.627,95％ CI 4.691 - 58.934; P =0.000),and long-term taking CCB (OR 4.147,95％ CI 1.053 - 16.332;P =0.042),and ACEI/ARB (OR 4.841,95％ CI 1.539 - 15.231; P =0.007) were the independent risk factors for CR.Conclusions CR in patients with ischemic stroke is associated with a variety of factors,in which diabetes,increased TC,as well as long-term taking CCB and ACEI/ARB are the independent risk factors for CR.

Objective To evaluate the efficacy and safety of proton pump inhibitor (PPI)plus prokinetic drug on the treatment of laryngopharyngeal reflex .Methods According to predetermined criteria of inclusion and exclu-sion ,Cochrane Central Register of Controlled Trails(CENTRAL) ,Embase ,Elsevier ,Pubmed ,VIP ,Wanfang Data , CNKI and CBM were searched for the randomized controlled trails of proton pump inhibitor and prokinetic drug on the treatment of laryngopharyngeal reflex diseases from the date of establishment of the datebases to November 2012 .Revman 5 .1 software and GRAED profiler 3 .6 software were applied to analysis the data ,which was extrac-ted by three independent evaluators .Results A total of 346 related articles were obtained ,7 trails were included , 614 patients in total .The results of Meta -analysis showed that :the overall effictive rate of combination therapy with proton pump inhibitors plus prokinetic drug in patients with laryngopharyngeal reflex was higher than those in the control group [RR=1 .18 ,95% CI(1 .10 ,1 .28) ,P<0 .0001] .The rate of improvement of laryngeal signs exam-ined by fiberoptic laryngoscope was higher than those in the control group [RR= 1 .38 ,95% CI(1 .16 ,1 .65) ,P<0 .001] .The average relief time of dysphonia symptoms was shorter than those in the control group [MD = -1 .70 , 95 CI (-2 .95 ,-0 .45) ,P<0 .001] .Conclusion The effect of proton pump inhibitor plus prokinetic drug on the treatment of laryngopharyngeal reflex is superior to those of proton pump inhibitors or prokinetic drug only ,but in terms of safety ,more large-sample ,high-quality randomized controlled trails are required .

Objective To evaluate the protection of 3-aminobenzamide (3-AB),an inhibitor of Poly (ADP-ribose) polymerase (PARP),on severe acute pancreatitis associated adenohypophysis injury in rats.Method Forty Wistar rats were randomly divided into 4 groups:sham operation group (SO group,n=8),SAP group (n=12),3-AB pretreatment group (n =12),drug control group (n =8).The bilepancreatic duct was cannulated through the duodenum and SAP model was induced by a standardized pressure-controlled retrograde infusion of 5％ sodium taurocholate (0.1 ml/100 g) into the bile-pancreatic duct.In 3-AB group,3-AB (20 mg/kg) was administered via femoral vein 30 min prior to the operation;other procedures were identical to SAP group.In SO group,pancreas was flipped several times only.In drug control group,3-AB (20 mg/kg) was administered via femoral vein 30 min prior to the operation.Serum amylase,lipase were measured.Pancreas and pituitary tissue were taken for pathological examination under light microscope.PARP and NF-κB antibodies for adenohypophysis immunohistochemical stains.Adenohypophysis cell was observed under electronic microscope.Result Serum amylase,lipase and pancreas pathological scores were significantly higher in 3-AB group compared with SO group (P ＜ 0.05),but lower than that in SAP group (P ＜ 0.05).Adenohypophysis pathological injury was less severe in 3-AB group.Expressions of PARP and NF-κB in adenohypophysis cells were significantly higher in 3-AB group compared with SO group,but lower than that in SAP group (P ＜ 0.05).Ultrastructural change of thyrotroph cell was relieved in 3-AB group.No significant difference was observed between SO group and drug control group in PARP and NF-κB expression nor adenohypophysis pathological injury.Conclusions 3-AB exerts the protective effect against acute pancreatitis associated adenohypophysis injury by inhibition of PARP and NF-κB.

Objective To investigate the changes of poly-ADP-ribose polymerase (PARP) and NF kappa B (NF-κB) in adenohypophysis in rat model of severe acute pancreatitis (SAP),and their role in the mechanism of adenohypophysis injury in SAP.Methods Forty Wistar rats were randomly (random number) divided into 5 groups:the sham operation group (SO group,n =8),SAP 1 h,3 h,6 h and 12 h groups (n =8 in each group).SAP model was induced by retrograde injection of 5％ sodium taurocholate into the biliopancreatic duct.Serum levels of amylase,lipase and ascites were measured.After sacrifice of experiment rats,pancreas and adenohypophysis tissues were taken for pathological examination under light microscope.Adenohypophysis cells were observed under electronic microscopy as well.PARP and NF-κB expressions in adenohypophysis cell was studied by using immunohistochemisty assay.Results After modelling,serum levels of amylase,lipase and ascites in SAP group increased gradually,which were higher than those in SO group (P ＜ 0.05).Adenohypophysis cell swelling and partial necrosis were observed under light microscope.As the time prolonged,their nuclei became dark and pyknotic more and more,and the endoplasmic reticulum and mitochondrial swelling in adenohypophysis cells were observed under electronic microscopy.The expressions of PARP and NF-κB in SAP group increased gradually,which were higher than those in SO group.Conclusions Significant pathological and ultrastructural injuries were observed in adenohypophysis cells in severe acute pancreatitis.These changes might correlate with PARP and NF-κB signaling pathway.

94 cases with 148 abutments treated by all-ceramic restoration in premaxillary teeth region were randomly divided into 4 groups, and the impressions were prepared by one-step method,double curettage method,double polish method and double microfilm method respec-tively using 3M ESPE Vinyl polysiloxane as impression material.The cervical margin precision of the impressions was compared.Four kinds of impression method can produce qualified impression.Double polish method is easy to teach and learn.

ObjectiveTo find out the effect of improving cooking stove to reduce fluoride in burning coal fluorosis areas in Ankang city Shaanxi province,and to provide a basis for continuing the consolidation of control measures and the elimination of the hazards of burning coal fluorosis.Methods According to the results of a census of 2001 in Ankang city on burning coal fluorosis,cluster sampling method was used in 2009,and 10％ of the diseased villages were included in the study according to the state of the disease(mild,moderate and severe) in seven counties.In each selected village 10 households were selected,and the quality of improved stoves was checked door to door,maintenance and satisfaction of the stoves were asked on the spot,and health education questionnaire was carried out among housewives.Thirty village primary schools were investigated,dental fluorosis of children aged 8 to 12 was checked by Dean method,urinary fluoride was tested by ion selective electrode,health education and knowledge questionnaire survey was curried out.Results A total of 1000 households were investigated in the seven diseased counties,and the completion rate of improved stoves was 90.00％ (900/1000);the rate of improved stoves in good condition was 87.14％ (630/723); overall use of improved stoves was 80.33％(723/900); proper use of improved stoves was 79.39％ (574/723),satisfaction rate of improved stoves was 86.89％(782/900),and self-maintenance of improved stoves was 8.00％(72/900).Total detection rate of dental fluorosis of children aged 8 to 12 was 23.74％(509/2144),dental fluorosis index was 0.50.Awareness of prevention knowledge among housewives and students was 65.20％ (2608/4000) and 83.36％(4518/5420),respectively.A total of 358 urine samples of children aged 8 to 12 were tested,urine fluoride ranged 0.16 - 6.35 mg/L,and geometric mean 0.79 mg/L.Conclusions The implementation of defluoridation project by improving cooking stove has achieved the goal of prevention and treatment of fluoride poisoning in burning coal fluorosis areas of Ankang city.Local residents are satisfied with the improved stoves,and most of the improved stoves are used constantly.The detection rate of dental fluorosis is less than 30％ of the control line.Some furnace are damaged,correct usage rate is not high.There is a need to further strengthen the management of the project and strengthen health education interventions to improve stove maintenance outlets,and make sustained control of the disease.

Objective To investigate the promotion effect of human transcriptional positive cofactor 4 (PC4) overexpression on lymphatic metastasis in lung adenocarcinoma .Methods 96 samples of lung adenocarcinoma tissue were collected .The immuno‐histochemistry(IHC) and real‐time quantitative polymerase chain reaction (qRT‐PCR) were adopted for detecting the expression levels of PC4 protein and mRNA .The correlation of PC4 expression with lymphatic metastasis and TNM stage was analyzed .Re‐sults The expression of PC4 protein was positively correlated mRNA in lung adenocarcinoma (r=0 .63 ,P<0 .01);the expression of PC4 protein was positively correlated with lymph node metastasis (χ2 =8 .29 ,P<0 .01) and TNM stage (χ2 =4 .71 ,P<0 .05);the expression of PC4 mRNA was also positively correlated with lymph node metastasis (χ2 = 8 .40 ,P< 0 .01) and TNM stage (χ2 =5 .10 ,P<0 .05) .Conclusion PC4 overexpression is found to be closely associated with the lymph node metastasis and TNM stage .PC4 may facilitate the lymph node metastasis of lung adenocarcinoma .

Objective To investigate the expression of intestinal epithelial stem cell markers Msil and Hesl in mouse acute radiation enteritis (RE) model. Methods Forty female BALB/c mice were undergone one-time whole abdominal irradiation by 300 cGy/min β-ray. Thirty mice were selected before irradiation (Day 0) and every six mice were euthanized at day 3,5,7 and 14 after irradiation. The small intestinal were detached and the expression of Msil and Hesl were detected in middle part of small intestinal by quantitative RT-PCR, Western blots, and immunohistochemistry. Subsequently,the difference of Msil and Hesl expression was compared. Results The mouse acute RE model was successfully established. At the 5th day after radiation, the results of quantitative RT-PCR indicated that the relative ΔCt value of Msil and Hesl expression were 15. 17 ± 0. 47 and 15. 83 ± 0. 24respectively, the results of Western blot showed that the integrated intensity were 0. 443±0. 055 and 0. 301 + 0. 047 for Msil and Hesl. The expressions were significantly higher than other time points at RNA and protein levels (P<0. 05). The results of immunohistochemistry revealed that Msil and Hesl were highly expressed in intestinal crypts at 5th day and 7th day. Conclusions The expression of Msil and Hesl, upregulated before wound repair in RE model, indicates that intestinal epithelial repair is related to intestinal stem cell proliferation.

Objective To compare the curative effect of internal fixation treatment between reconstruction-type intramedullary nailing and long anatomic proximal femoral locking plate for patients with ipsilateral femoral proximal and shaft fractures. Methods Twenty-six patients with ipsilateral femoral proximal and shaft fractures were selected, among whom 12 patients were treated with reconstruction-type intramedullary nailing internal fixation treatment (group A), and 14 patients were treated with long anatomic proximal femoral locking plate internal fixation treatment (group B). The fracture to operation time, operation time, intraoperative blood loss, fracture healing time and hip joint function according to Majeed function score were compared between 2 groups. Results The fracture to operation time, operation time, intraoperative blood loss, proximal femoral fracture healing time, femoral shaft fracture healing time and Majeed function score in group A were (6.65 ± 4.11) d, (131.08 ± 20.70) min, (470.83 ± 96.43) ml, (17.83 ± 2.70) weeks, (20.08 ± 3.97) weeks and (83.83 ± 8.13) scores, and those in group B were (7.13 ± 4.56) d, (141.86 ± 27.30) min, (553.57 ± 127.80) ml, (18.29 ± 5.12) weeks, (21.55 ± 4.19) weeks and (83.21 ± 9.58) scores, and there were no statistical differences (P>0.05). According to Majeed function score, in group A excellent was in 7 cases, good in 4 cases, and general in 1 case; in group B excellent was in 9 cases, good in 3 cases, and general in 2 cases. Conclusions A fixation device fixes two fracture is preferred. Both treatment methods used in the present study could achieve satisfactory curative effect, and should be chosen according to the fracture type of the patients and the surgeon′s familiarity for the methods of internal fixation chosen. The proximal femoral fracture should preferably be reduced and stabilized first. A delay of 5 - 6 d would not affect the ultimate curative effect.

The paper aimed to elucidate the specific impact of supramolecular chemistry on the Chinese medicine theories (CMT) in their modernization, after had summarized up the research status of supramolecular chemistry and analyzed the possible supramolecular forms of Chinese medicine (CM), as well as considered the problems in modernization of CM theories. On comparison of the classical chemistry that delt with chemical bonds among atoms, the supramolecular chemistry was rather concerned with varietes of weak noncovalent bonds intermolecules, and reflected the macro-apparent chemical properties of each molecules, and was the most appropriate chemical theories to explain the CMT and microcosmic materials. The molecules in the human body and Chinese material medica (CMM) formed supramolecules by way of self-assembly, self-organization, self-recognition and self-replication, with themselves or with complexation, composition, chelation, inclusion, neutralization etc. Meridian and Zang-fu viscera in CMT might be a space channel structure continuously consisted of unique molecules cavity that was imprinted with the supramolecularly template inside and outside of cells, through which the molecules in CMM interacted with the meridian and Zang-fu viscera. When small molecules in human body imprinted with macromolecules in meridian and Zang-fu viscera, in other words, they migrated along within imprinting channels of meridian and Zang-fu viscera on behavior of "Qi chromatography" impulsed by the heart beat, finally showed up on macroscopic the anisotropy of tissue and organ, as described namely as visceral manifestation in Chinese medical science. When small molecules in CMM interacted with imprinting channel on meridian and Zang-fu viscera, the natural properties and efficacy regularities of CMM was reflected on macroscopic. Therefore, the special representation forms of basic CMT is based on the macroscopic expression of "Qi chromatography" abided by imprinting effect regularities, and on whether the imprinted template of small molecules matched with cavity template of macromolecules in meridian and Zang-fu viscera, only is the adequate representation of supramolecular chemistry for them. The CMM materials is the mixture including single molecules and supramolecules. The compatibility for CM prescriptions can significantly change the function rules. Therefore in the study of basic CMT, we should pay special attention to the laws of supramolecular chemistry. It is the most essential differences of the CMT from the modern medicine which established by the laws of single molecular theories.
Chemistry, Pharmaceutical ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Meridians ; Nanotechnology